The task
Assume that today's date is 22 October 2026. Mr Vargas came into the pharmacy this morning to collect another salbutamol inhaler.
You are a community pharmacist. Using the information in the case notes, write a letter to Mr Vargas's GP, Dr Mette Schreiber, to update her on his asthma medication use, symptoms and inhaler technique, and to request a review. Address the letter to Dr Mette Schreiber, General Practitioner, The Medical Centre, 45 Main Street. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Update letter.
Case notes
Patient details
- Name: Mr Rodrigo Vargas
- DOB: 14/03/1992 (34 yrs)
- Address: 12 Park Lane
- Regular GP: Dr Mette Schreiber
Social background
- Forklift driver in warehouse; says workplace is dusty
- Smokes 3–4 cigarettes/wk, socially
- Plays five-a-side football weekly
- Lives with partner; says partner 'nags him all the time about his snoring'
- Complained about waiting 20 min in pharmacy queue today; 'staff too slow'
Medical history
- Asthma since childhood; last hospital admission aged 15
- Seasonal allergic rhinitis — OTC loratadine PRN
- Tonsillectomy aged 8
- Allergies: nil known
- No written asthma action plan
Dispensing record
- Fluticasone propionate 125 microg MDI, 1 puff BD — last dispensed 20/06/26 (1 inhaler ≈ 2/12 supply at prescribed dose)
- Salbutamol 100 microg MDI, 1–2 puffs PRN — 6 inhalers dispensed 22/07/26–20/10/26 (≈ 3/12)
Counselling 22/10/26
- Stopped preventer ≈ 2/12 ago when it ran out — 'felt fine'; worried steroids cause weight gain
- Waking with cough & wheeze 3–4 nights/wk over past 4/52
- Uses reliever most days, incl. before football
- No ED visits; denies chest pain; speaking in full sentences, no acute distress today
- Inhaler technique: does not shake MDI, finishes inhaling before actuating, with no further inhalation after the puff, no breath-hold, no spacer
- Says a friend told him salbutamol 'cures' asthma
Pharmacist action
- Explained preventer vs reliever; addressed concerns re steroid side effects
- Demonstrated MDI + spacer technique; pt demonstrated correct technique back
- Spacer supplied; fluticasone dispensed today (valid repeat on script)
- Advised: if severe breathlessness or reliever not helping → call 000
- Smoking cessation advised; Quitline info given
- Pt asked for cheaper loratadine — generic brand supplied
- Phoned Dr Schreiber's surgery 22/10 — spoke to practice nurse; reliever overuse & nocturnal sx reported → GP triage today & earlier review requested
Plan
- Request expedited GP review ASAP (not to wait for routine appt): asthma control, treatment, written asthma action plan
- Pt has booked routine appt with Dr Schreiber 28/10/26 — retain as follow-up after earlier review
- Pharmacy to recheck technique & adherence at next refill
Who is reading, and what do they need?
Dr Schreiber is his regular GP and knows his asthma history. Her practice nurse was already phoned today about reliever overuse and night symptoms, so the letter backs up that call with the pharmacy findings. She needs the evidence for an earlier review and what the pharmacy has already done, not general background.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Preventer stopped about 2 months ago when it ran out | The lapse in fluticasone is the main finding behind the poor control, so the GP needs it stated clearly. |
| Felt fine; worried steroids cause weight gain | His stated reasons for stopping guide the GP's counselling, and the pharmacist has already addressed the concern. |
| Waking with cough and wheeze 3–4 nights/wk over past 4 weeks | Night symptoms are the clinical evidence of current poor control and support the request for early review. |
| 6 salbutamol inhalers dispensed 22/07–20/10; uses reliever most days, including before football | Dispensing records give objective evidence of reliever reliance that the GP cannot see herself. |
| Technique errors: no shaking, inhales before actuating, no breath-hold, no spacer | Faulty technique may affect how well either inhaler works, so the GP should know what was found. |
| Correct technique demonstrated back; spacer supplied; fluticasone dispensed today | Tells the GP what has been corrected and that he has the preventer again, so she does not repeat it. |
| No ED visits, no chest pain, full sentences, no acute distress today | Gives the GP his state today without overstating it, and shows why the request is early review, not emergency. |
| No written asthma action plan | This is a gap that links directly to what the pharmacist asks the GP to address. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Complained about 20-minute queue and slow staff | A service complaint has no bearing on his asthma care and does not belong in a clinical letter. |
| Partner nags him about snoring | Social remark, not an assessed symptom; nothing in the notes links it to his asthma. |
| Cheaper generic loratadine supplied | Minor, resolved over-the-counter matter unrelated to the asthma review. |
| Tonsillectomy aged 8; last admission aged 15 | Remote history that the GP already holds and that adds nothing to the current problem. |
| Dusty workplace; smokes 3–4 cigarettes a week | Looks like possible triggers, but the notes do not link them to his symptoms; at most a brief mention of the cessation advice. |
| Advised to call 000 for severe breathlessness or reliever not helping | Patient advice that does not help the GP's decision; a partial first-aid list could mislead, so keep only what is recorded or omit. |
A paragraph plan for this case
Open with the purpose and the request for an earlier review than the routine slot. Then cover the preventer lapse and reasons, symptoms and reliever supply, followed by technique findings and pharmacy actions. Close by listing what to review and noting the 28/10 appointment stays as follow-up.
Where candidates slip on this task
- Keep dates and durations as recorded: fluticasone last dispensed 20/06/26, stopped about two months ago, symptoms over the past four weeks. Do not invent trends or calculate extra figures beyond the notes.
- The 28/10/26 appointment is a retained follow-up, not the review requested. Make clear that the purpose is an earlier, expedited review covering control, treatment and an action plan.
- Describe the inhaler errors exactly as recorded and do not state that poor adherence or technique has caused his symptoms; present them as findings the GP should consider.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
More Pharmacy letter tasks
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- School principal asking about a student's adrenaline autoinjector response letter
- Nurse manager asking about crushing medicines for a resident response letter
Your profession's guide: OET Pharmacy. Layout and structure: OET letter format.
Questions about this task
Should I mention the phone call to the practice nurse?
Yes, briefly. It shows the GP that the surgery has already been told and triaged, so the letter confirms it and supplies the detail. Avoid repeating the whole call or implying the nurse's response.
How much of the counselling should I include?
Only what changes the GP's picture: concerns about steroids, the technique corrections, the spacer and today's supply. Leave out smoking and workplace detail or compress them, since the notes do not link them to his symptoms.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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