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.
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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.
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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.