Pharmacy — Advice Letter on Using a New Inhaler for COPD
A pharmacist writes an advice letter to a 66-year-old man who has been prescribed a new dry-powder combination inhaler for COPD. The letter must explain the correct technique, the difference between this preventer and his existing reliever inhaler, and what to do if his breathing worsens — in plain patient language.
Letter type
Advice
Write to
Patient
Target length
180–200 words
The case notes
Patient: Mr Raymond Tran, 66 years old; smoker (has been offered smoking cessation — declined)
Diagnosis: COPD (GOLD Stage II); prescribed new Salmeterol/Fluticasone 50/500 Accuhaler (combination preventer inhaler) by GP today
Existing inhaler: Salbutamol 100 mcg MDI (blue reliever) — unchanged; patient uses this correctly
New inhaler technique: Accuhaler: slide, click, breathe in steadily and deeply (not fast); hold breath 5–10 seconds; do not shake; rinse mouth after use to prevent oral thrush
Frequency: Salmeterol/Fluticasone: one inhalation TWICE daily (morning and evening) — not for acute breathlessness
Important distinction: Salbutamol (blue) is for immediate breathlessness; Accuhaler is preventive and must be taken daily even when feeling well
Oral thrush prevention: Rinse mouth and gargle with water after each use; spit out
Worsening symptoms: If breathlessness gets significantly worse or salbutamol provides no relief after two doses — contact GP or attend emergency department; do not increase Accuhaler frequency
Task: Write an advice letter to Mr Tran explaining how to use his new Accuhaler correctly, when to use each inhaler, and what to do if his symptoms worsen.
Writing task
Write an advice letter to Mr Tran explaining how to use his new Accuhaler correctly, when to use each inhaler, and what to do if his symptoms worsen.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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The Accuhaler technique: slide, click, steady deep breath, hold, rinse after
Incorrect technique with a dry-powder inhaler means little or no drug reaches the lung. The technique must be described in a sequence the patient can follow at home after reading the letter.
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The distinction between the two inhalers: preventer vs reliever
This is the most common patient confusion. Patients who only use the blue inhaler for symptoms and never use the preventer, or who use the preventer for acute symptoms, both get suboptimal outcomes.
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The safety net: what to do if salbutamol does not work after two doses
A patient with severe COPD who has an unresponsive exacerbation needs to know exactly when to call for help. Vague 'seek help if concerned' is insufficient.
Leave out
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Smoking cessation in this letter
Already offered and declined. Repeating it in the advice letter breaches the patient relationship and is not the purpose of this communication. A brief mention at most — do not make it a sub-section.
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The pharmacology of corticosteroids and long-acting beta-agonists
Wrong register for a patient letter. 'The steroid reduces inflammation and the bronchodilator relaxes the airways' is one plain sentence — that is the right level of explanation.
Criterion in focus · Organisation & Layout
An inhaler technique letter has a natural three-part structure: (1) how to use the new inhaler (technique steps), (2) when to use each inhaler (preventer vs reliever), (3) what to do if symptoms worsen (safety net). A letter that presents these in a random order confuses the patient and loses Organisation & Layout marks. The structure mirrors the patient's sequence of questions.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words advice letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.