Respiratory Clinic Letter
Created by
Riaan Venter
Specialty
Respiratory Physician
Last edited
10/20/2026
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About this template
A reusable letter structure for respiratory specialists to communicate a patient's primary respiratory diagnosis, clinical background, examination findings, investigations, and management recommendations to other healthcare professionals or caregivers. It also includes recipient, patient-identification, sign-off, and copy-recipient details.
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Prepared on: 14/05/2024
Dr Thabo Mbeki Sandton Family Practice, 45 Rivonia Road Sandton, Johannesburg, 2196
Dear Thabo
Regarding: Sipho Ndlovu NHI: ZA-8492014-7 Date of birth: 12/08/1962
Primary Respiratory Diagnosis
- Chronic obstructive pulmonary disease (COPD) – GOLD Group E
Management Plan
- Commence fluticasone furoate/umeclidinium/vilanterol (Trelegy Ellipta®) 100/62.5/25 mcg INH OD, refer for pulmonary rehabilitation, and review in 3 months.
Thank you for referring Mr Ndlovu for evaluation of his worsening exertional dyspnoea and recurrent infective exacerbations over the past 6 months, which have required two courses of oral corticosteroids.
Mr Ndlovu has a 35-pack-year smoking history, having quit 2 years ago. His medical history is notable for essential hypertension and T2DM, managed with amlodipine 5 mg PO OD and metformin 1,000 mg PO BID. Current respiratory therapy consists of tiotropium (Spiriva®) 18 mcg INH OD and salbutamol (Ventolin®) 100 mcg INH PRN. He worked in construction for 20 years with minor occupational dust exposure, but no known asbestos exposure.
On examination today at 10:30, he was comfortable at rest with SpO2 94 % on room air, BP 135/82 mmHg, HR 78 bpm, and BMI 24.5 kg/m². Chest auscultation revealed diffusely reduced breath sounds with a prolonged expiratory phase and scattered expiratory wheezes bilaterally; JVP was not elevated and there was no peripheral oedema. Spirometry demonstrated severe airflow obstruction with a post-bronchodilator FEV1 of 1.25 L (46 % predicted), FVC 2.95 L (82 % predicted), and an FEV1/FVC ratio of 0.42, with no significant reversibility. CXR showed hyperinflation with flattened hemidiaphragms and no focal consolidation or mass lesions. FBC noted an eosinophil count of 0.35 x 10^9/L.
Given his frequent exacerbations and elevated blood eosinophils, I have stepped up his therapy to single-inhaler triple therapy with fluticasone furoate/umeclidinium/vilanterol (Trelegy Ellipta®) 100/62.5/25 mcg INH OD, discontinuing his tiotropium. Inhaler technique was checked and optimised today. I have referred him to the local pulmonary rehabilitation programme and advised that he receive his annual influenza and pneumococcal vaccinations at your clinic. I will review him in the respiratory clinic in 3 months with repeat spirometry.
Yours faithfully
Dr Zanele Khumalo Respiratory Physician
Copy to: Sipho Ndlovu Milpark Hospital Pulmonary Rehabilitation Unit
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