RT Journal Article SR Electronic T1 M5 Virtual clinics for chronic lung disease-comparison and learning from patient groups in primary care & integrated respiratory care services JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP A239 OP A239 DO 10.1136/thoraxjnl-2017-210983.427 VO 72 IS Suppl 3 A1 Cornwallis, J A1 Purlackee, S A1 Ahmed, A A1 Hassan, R A1 Ng-Man-Kwong, G YR 2017 UL http://thorax.bmj.com/content/72/Suppl_3/A239.1.abstract AB Introduction and Aims The virtual clinic (VC) was designed to identify and review patients with COPD diagnosis and/or FEV1 ≥50% predicted and/or on high dose inhaled corticosteroids (ICS) to recommend interventions to optimise care. Our study piloted VCs across 2 patient groups in primary care (PC) and under the care of our local integrated respiratory care service (IRCS). The aims were to identify patients who would benefit from national guideline based interventions such as modification of inhaler therapies, pulmonary rehabilitation (PR) and/or additional specialist advice.Results VCs were undertaken in six PC health centres with GP and/or practice nurse and for IRCS group respectively. In total 161 patients were reviewed (PC group 94/161 (68%) and IRCS 67/161). Mean age 63 years (range 38–96), male 67/161 (42%), mean% predicted FEV1 51% (range 11–117). Overall 98/161 (60%) had potential change in inhaler therapy identified, PC 55/94 (59%) and IRCS 43/67 (64%) respectively (p=0.47 NS). 40/161 (25%) had recommendation to stop or wean ICS (PC 28/94 (30%) and IRCS 12/67 (18%, p=0.08 NS). 47/161 (29%) recommended referral for PR (PC 38/94 (40%) vs IRCS 9/67 (13%), p<0.01). For the PC group 22/94 (23%) were referred to IRCS and 3/94 (4%) were removed from COPD register. 8/161 (5%) were identified as potentially requiring HRCT investigation, 7/94 (7%) in the PC group.Conclusion Virtual Clinics as part of an Integrated Respiratory Care Service can generate important treatment optimisations including inhaler modification in nearly two thirds (trial of ICS cessation in 25%) and PR referral in one third of reviews (significantly in the PC group). VCs confer patient benefit, support medicines management, PC training and education (including quality assurance) and effective and efficient use of specialist time.