Pharmacy · Medication clarification letter · Task 1

Conflicting discharge medicine lists

You are a pharmacist. The case notes below record your work on 13 September 2026. Write to Dr James Carter, General Practitioner, Brookfield Medical Practice, 28 Cedar Close, Brookfield. Request same-day clarification of the intended bisoprolol regimen from the patient’s GP practice. Include the telephone escalation and the need for advice before the next scheduled dose. Select the information this recipient needs and write approximately 180-200 words in the body.

Patient: Nora Ellis

Case notes

• N01Date: 13 September 2026. Patient: Nora Ellis.
• N02Yesterday: discharged after heart failure admission.
• N03Discrepancy: discharge summary bisoprolol 5 mg daily; repeat prescription 2.5 mg daily; both strengths at home.
• N04Patient unsure which packet to use; no replacement supply dispensed today.
• N05Patient reports no extra compensatory tablet taken.
• N06Current reported symptoms: no dizziness, chest pain or breathlessness at rest; reports do not establish appropriate dose.
• N07Pharmacist has not chosen a dose.
• N08Action: telephone message to duty clinician today; advice needed before next scheduled dose.
• N09Plan: Dr James Carter, GP; confirm intended regimen; update prescription if necessary; communicate directly to patient/pharmacy.
• N10Practical: daughter can collect today; patient consents to document sharing.
• N11Enclosures: discharge summary/repeat prescription copies.
• N12Background: used same pharmacy before house move; previously worked as a receptionist.
• N13Recipient: Dr James Carter, patient’s GP at Brookfield Medical Practice; practice to coordinate the prescribing response.