OET letter for an asthma patient: inhalers, triggers, action plans and follow-up
In an OET Nursing letter about a patient with asthma, state the reason for the letter and the recent attack in one or two sentences, then give what the reader needs to continue care: current inhalers and any changes, inhaler technique or spacer use, known triggers, the written action plan if the notes mention one, and the follow-up requested. Leave out routine observations and the full emergency-department story unless a detail changes the reader's plan.
What the reader of an asthma letter needs
Asthma cases in OET-style practice usually follow a hospital stay or an emergency visit after an attack. The reader is often a GP, a practice nurse, an asthma nurse, or a school nurse. Each of them needs to know three things: what happened, what has changed in the treatment, and what they must do next.
Use this question for every note: will the reader do anything differently because of this? If not, it probably belongs out of the letter. For a general method, see how to select case notes.
What to include and what to leave out
| Usually include | Usually leave out (unless it changes the plan) |
|---|---|
| Reason for admission or visit in one sentence | Every observation taken in the emergency department |
| Likely trigger (for example a cold, pollen, smoke, exercise) | Full list of nebuliser times and doses |
| Current inhalers, doses and any changes | Old inhalers stopped years ago |
| Inhaler technique problems and spacer use | Normal chest X-ray details, if no action follows |
| Adherence concerns stated in the notes | Hospital ward name and bed number |
| Written asthma action plan, if the notes mention one | Detailed family history with no bearing on care |
| Smoking status of patient or household, if relevant | Hobbies unrelated to triggers |
| Follow-up requested and by when | Every staff member who saw the patient |
All the rows are examples, not rules. The case notes and the writing task decide what is relevant.
How to describe inhalers clearly
Inhaler sentences are where many letters lose clarity. Give the name as written in the notes, the dose, and the frequency. Group "reliever" and "preventer" medicines if the notes use those words.
| Unclear | Clear |
|---|---|
| "She uses her inhalers." | "She uses a preventer inhaler twice daily and a reliever inhaler when needed." |
| "Inhaler changed." | "Her preventer dose was increased during admission, as listed below." |
| "Technique poor, spacer given." | "Her inhaler technique was poor, so she was given a spacer and shown how to use it." |
| "Non-compliant with preventer." | "She reports often forgetting her evening preventer dose." |
For layout of several medicines, see how to write medications in an OET letter. For neutral wording about adherence, see non-adherence and sensitive information.
Accuracy note: copy medicine names, doses and instructions from the case notes. Do not add clinical advice, dose ranges or treatment steps that the notes do not contain. This guide is about writing, not asthma management.
Paragraph plan for a discharge letter to a GP
- Purpose: who the patient is, why you are writing, and the main request.
- Admission: date, reason, likely trigger, main treatment, response.
- Current treatment: inhalers and changes, technique and spacer, action plan.
- Social and risk factors: smoking, housing or work triggers, adherence, if relevant.
- Request: review date, what to check, and who to contact.
For more detail on opening sentences and closing requests, see opening sentence examples and closing paragraph examples.
Worked example: adult discharge (invented case)
Notes (invented): Ms Hana Okoro, 34, office worker. Asthma since childhood. Admitted 8 Mar with acute asthma after a chest infection. Treated with nebulisers and oral steroid; improved. Discharge 10 Mar. Preventer inhaler dose increased. Reports using reliever 5–6 times a day before admission. Technique poor — spacer given and taught. Written action plan given. Lives with partner, who smokes outdoors. Oral steroid to finish 13 Mar. GP review within 1 week.
Weak opening:
Ms Okoro is a 34-year-old office worker who has had asthma since she was a child and was admitted on 8 March with acute asthma after a chest infection and was treated with nebulisers and an oral steroid and she has improved.
Better letter body:
I am writing to inform you of Ms Okoro's discharge today following an admission for acute asthma, and to request a review within one week.
Ms Okoro was admitted on 8 March with an acute asthma attack, which was likely triggered by a chest infection. She was treated with nebulisers and a course of oral steroids, and she responded well.
Before admission, she reported using her reliever inhaler five to six times a day. Her preventer dose has therefore been increased. As her inhaler technique was poor, she was given a spacer and shown how to use it. She has also been given a written asthma action plan. She should complete the oral steroid course on 13 March.
Ms Okoro lives with her partner, who smokes outdoors.
I would be grateful if you could review Ms Okoro within one week, in particular her reliever use and inhaler technique.
The letter leaves out the nebuliser timings and her job, because neither changes what the GP does next.
Worked example: child, letter to a school nurse (invented case)
Notes (invented): Leo Marsh, 8. Asthma. Emergency visit 2 Oct after attack during PE (exercise trigger). Reliever before exercise now advised by doctor. Mother, Mrs Ana Marsh, manages inhalers. Action plan copy for school. Leo can use inhaler with spacer independently but needs reminding.
Key sentences:
I am writing regarding Leo Marsh, aged eight, who attended our emergency department on 2 October after an asthma attack during a physical education lesson.
His doctor has advised that he should use his reliever inhaler, with his spacer, before exercise. Leo can use the inhaler himself but may need a reminder. A copy of his asthma action plan is enclosed for the school.
I would be grateful if you could ensure that his inhaler and spacer are available during sports lessons. If you have any questions, please contact his mother, Mrs Ana Marsh.
The language is plainer because the reader is not a doctor. See writing to a non-clinical reader and letters about child patients.
Common mistakes in asthma letters
- Copying every observation. A list of saturations and peak flows at each hour hides the important change.
- Vague medicine wording. "Inhalers continued" does not tell the reader which inhaler or what changed.
- Judgemental language. "Non-compliant" or "refuses to stop smoking" sounds critical; report what the notes say neutrally.
- No clear request. The final paragraph should say exactly what the reader should do and by when.
- Adding advice not in the notes. Do not invent a review interval, dose, or treatment step.
Practise and check
Practise a timed letter at /writing/, or check a letter you have written to get an estimated grade, a mark for each criterion and line-by-line corrections. medEmu is an independent practice tool for OET Writing for Nursing; its grades are estimates, and it is not affiliated with OET.
Related: COPD and respiratory letters, infection and antibiotics and the Content criterion.
Sources
This guide is medEmu's writing advice, not official OET guidance and not clinical advice; all patients, medicines and plans are invented for practice, and a real letter must follow the case notes. The network used for this run could not reach oet.com, so no OET test facts are stated beyond the criterion names. For OET's official Writing information, see oet.com.