P227 Qualitative exploration of healthcare-seeking experience of patients diagnosed with active tuberculosis in Leicestershire, UK

<h3>Introduction</h3> Multiple patient and healthcare factors contribute to delays from symptom onset to the start of treatment for tuberculosis (TB). This study aimed to explore barriers and facilitators to early care-seeking for patients previously diagnosed with TB in Leicestershire. <h3>Methods</h3> This qualitative study was performed using semi-structured interviews with adult patients treated for active TB between 2019–2023. Purposive sampling was used to represent the local TB population. Participants completed a demographic questionnaire followed by in-person interviews analysed using thematic analysis. <h3>Results</h3> Ten interviews have been conducted to date (6 females, median age 34yrs). Four participants were South Asian, three White British, two Eastern European and one African. Median delay from symptom onset to the start of treatment was 12 weeks (range 1–130 weeks). The main themes identified from the interviews are summarised in table 1. Patient factors that delayed care-seeking included symptom minimisation and denial, which continued until either sudden deterioration or external pressure from others triggered healthcare engagement. Several participants expressed loss of trust in the system associated with negative experiences including delayed appointments, multiple appointments to address persisting symptoms, or if symptoms were dismissed. Frustration with access and efficiency in the NHS led two participants to seek healthcare abroad. Importantly, patients reported a change in these perceptions with positive healthcare experiences during the TB treatment period that helped rebuild future trust towards healthcare providers. These included feelings of being looked after, reassuring communication, including cross-cultural engagement. Following TB treatment, some patients stated a new willingness to engage with healthcare for future problems. Several participants mentioned incorrect prior knowledge of the disease and awareness of stigma about TB diagnosis. <h3>Conclusion</h3> Our findings highlight multiple interrelated patient and healthcare factors that variably contribute to delays in TB diagnosis. Education in the form of community information campaigns for the public and refresher teaching for clinicians are helpful to address misinformation raise awareness about TB. Importantly, the individual interactions of patients with healthcare providers during TB treatment have an important bearing on their trust and future healthcare engagement. Optimising care for TB patients may therefore have longer term secondary benefits to health.