P016 Socio-demographic determinants of care in systemic autoimmune rheumatic diseases: a mixed methods study of patients perceptions of care

Background/Aims Systemic autoimmune rheumatic diseases (SARDs) are chronic, multisystem conditions with rising global prevalence and significant social and biological determinants. Socio-economic characteristics, including ethnicity, gender and socio-economic status, are associated with prevalence and outcomes in systemic autoimmune rheumatic diseases. There is limited research into patient perceptions of how their socio-demographic characteristics impact their medical care. This study examines how socio-demographic factors are perceived to influence SARDs care quality in the UK and the Republic of Ireland, contributing to scholarship on health equity. Methods A co-produced online survey was shared internationally. Participants were asked how they felt that each of their sociodemographic characteristics had affected their treatment by clinicians with 6 options given from “much worse” to “much better” and including options for “no difference” and “unsure”. Chi-squared tests were conducted to assess differences in reported treatment and identify patterns of perceived inequalities. Statistical analyses of treatment perceptions are ongoing and centre on a series of Generalized Linear Models. Interviewing will continue until data saturation has been reached (no novel insights arising). Qualitative analysis is thematic and incorporates discussion of themes with a multidisciplinary team including patient partners. Results Surveys were completed online, with n = 2971 UK and the Republic of Ireland SARDs participants, 90% being female and 95% white. Qualitative responses were obtained from open-ended survey responses (n = 2287) and in-depth participant interviews (ongoing). Preliminary findings include statistically significant differences between how people feel they were treated across multiple sociodemographic characteristics, including gender, ethnicity and education. A greater proportion of women (27%) compared to men (7%) reported worse treatment due to gender (p < 0.001). Non-White (22%) compared to White (2%) participants reported worse treatment due to ethnicity, (p < 0.001). Participants with at least a post-secondary education (31%) reported better treatment than those with a primary or secondary education (6%; p < 0.001). Participants described how multiple factors interact to shape their care experience: “I think being overweight, middle aged & Indian definitely gave a negative first impression, but improved when I spoke perfect English, described my occupation & that I was running marathons until I started getting symptoms.” (South Asian, female, SLE, UK) Conclusion This study is of key importance for understanding the role of socio-demographic factors in shaping patient perceived quality of care. The results reaffirm the importance of not only understanding the reality of discrimination in clinical care, but also the need to attend to intersectionality in informing patient experiences. Our mixed-methods analyses provide insights into clinician-patient interactions in addition to the social and economic factors which shape patient satisfaction and health outcomes. Disclosure S. Taylor: None. L. Shepstone: None. R. Narendra Modi: None. K. Naidu: None. S. Tayabali: None. A. Taiwo: None. O. Adegbulu: None. A. Kaul: None. W. Diment: None. P. Karampoulas: None. D. D’Cruz: Consultancies; GSK, Eli Lilly, Vifor and UCB, and a leadership role on the board of APS support. M. Sloan: Consultancies; OtoImmune. Grants/research support; The Lupus Trust, Lupus UK, and Vasculitis UK.