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Poster sessionsThorax 2012;67(Suppl 2):A1-A204 A65could be impaired rather than AO deficiency. This needs to be researched further in larger studies. Adherence assessment prior to Omalizumab initiation was completed by all centres; however there was a varied approach of each centre in their assessment. 90.6% assessed prescription records, 74.4% questioned patients regarding medication adherence, 32.5% measured prednisolone levels and 4.6% utilised a validated questionnaire (4.6%) Longitudinally 48.8% continue to monitor adherence every 0-6 months, 27.9% every 6-12 months whilst 11.6% do not cheque adherence long term. Centres were diverse in their period of recommended observation post first dose. 4.6% advocate a 0-60 minute observation, 25.5% 1-2hrs, 39.5%, 2-3 hrs and 23.3% >4hrs, subsequent dose administration also varied across centre 37.2% advocated a 0-30min observation, 25.5% a 30-60min period and 11.6% 2-3hrs (11.6%). Paediatric centres advocated a longer observation period post injection. Across centres there is a huge inconsistency in weight observation 46.5% of centres weigh patients each visit, 27.9% 1-3 monthly and 16.2% 3-6 monthly. Dose of Omalizumab is only altered specific to weight fluctuation by 60.4% of which a higher percentage is practised in paediatric compared to adult centres (71.4%/55.1%). Out of dosing range prescribing is undertaken by 57.1% (paediatric) 29% (adult). Use of adrenaline auto injectors were not advocated by 60.4% of the centres, of the remaining 39.5% who advocate adrenaline auto injectors only 47% of this population have specific guidance relating to length of time to keep the injector available. Results of this audit provide evidence for the requirement for national evidence based guidelines, to procure a standardised collaborative approach regarding the use of Omalizumab for patients with severe persistent allergic asthma, with this in situ best practise can be delivered throughout the United Kingdom. OMALIZUMAB: A NATIONAL REVIEW OF PRACTISE ACROSS THE UNITED KINGDOM INTRODUCING BRONCHIAL THERMOPLASTY TREATMENT INTO A SEVERE ASTHMA CLINICAL SERVICE

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Background : Thoracentesis can be done for both therapeutic and diagnostic purposes, with the objective of symptomatic relief and improve of quality of life due to dyspnoea. The underlying mechanism for symptom relief following thoracentesis is multifactorial but principally includes progress in respiratory muscle mechanics with a smaller effect from progress in lung volumes and pulmonary function. Materials and Methods : This is prospective and randomized study was carried out on 90 patients who were admitted to the