Pharmacy · Advice letter · Intermediate

Pharmacy — Advice Letter for a New Warfarin Patient

A pharmacist writes to a patient newly started on warfarin after a DVT. The advice letter is graded on clear, patient-appropriate safety information: how to take it, monitoring, interactions and the warning signs that need urgent help — all in plain language, not clinical jargon.

Letter type

Advice

Write to

Patient

Target length

180–200 words

The case notes

Patient: Mrs Joan Pickering, 67 years old

Reason: Newly started on warfarin following a deep vein thrombosis (DVT) in the left leg

Dose: Warfarin, dose adjusted to INR; current 3 mg daily; take at the same time each evening

Monitoring: Regular INR blood tests at the anticoagulation clinic; target INR 2.0–3.0

Interactions: Avoid starting new medicines or supplements without checking; limit alcohol; keep vitamin K intake (green vegetables) consistent rather than changing suddenly

Warning signs: Unusual bruising, bleeding gums, blood in urine or stool, prolonged bleeding from cuts

Practical: Carry the anticoagulant alert card; tell any dentist or doctor she takes warfarin

History: Hypertension (amlodipine); occasional ibuprofen for knee pain — advise paracetamol instead

Task: Write an advice letter to Mrs Pickering explaining how to take her new warfarin safely and what to watch for.

Writing task

Write an advice letter to Mrs Pickering explaining how to take her new warfarin safely and what to watch for.

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

  • How and when to take the dose, and that it can change with INR

    The core instruction. The patient must understand the dose is not fixed and depends on blood tests.

  • The need for regular INR monitoring

    Without it the therapy is unsafe; this is the single most important behaviour to convey.

  • Bleeding warning signs and what to do

    Examiners reward a clear safety net in advice letters above almost any other content choice.

  • Switch from ibuprofen to paracetamol

    A concrete, decision-relevant interaction the patient can act on immediately.

Leave out

  • The pharmacology of warfarin / vitamin K antagonism

    Mechanism detail is wrong for a patient audience and breaches the register. Explain the why in plain terms instead.

  • Her hypertension management

    Unrelated to the warfarin advice unless it bears on an interaction; including it dilutes the purpose.

Criterion in focus · Conciseness & Clarity

Advice letters to patients live or die on register. Clinical terminology, dense sentences and jargon all cost Conciseness & Clarity and Genre & Style marks. The 2026 emphasis on clarity makes plain, actionable wording essential.

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.

Questions about this case note

What makes an OET advice letter different from a referral?
The recipient is the patient (or a carer), not a health professional. The register shifts to plain, supportive language, the focus is on what to do and what to watch for, and a clear safety net is essential. Clinical jargon that would be fine in a referral is a fault here.
How much detail about side effects should I include?
Enough to keep the patient safe, no more. Name the key warning signs of bleeding and say exactly what to do if they occur. A long catalogue of rare effects overwhelms the reader and costs clarity marks.

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