"Tell me so I know you understand": pharmacists' verification of patients' comprehension of antiretroviral dosage instructions in a cross-cultural context

Patient Educ Couns. 2009 May;75(2):205-13. doi: 10.1016/j.pec.2008.09.009. Epub 2008 Dec 13.


Objective: Patient comprehension of dosage instructions is an essential condition for adherence to treatment regimens, but previous studies show that pharmacists do not generally check understanding. This study aims to describe and discuss the effectiveness of various strategies for verifying patients' understanding of ARV dosage instructions in a cross-cultural context.

Methods: Twenty-six cross-cultural pharmacist-patient interactions in an ARV pharmacy in South Africa were analysed using Conversation Analysis techniques. Interviews with participants were analysed using Thematic Content Analysis.

Results: Various strategies for verifying patient understanding were identified in the data, including eliciting a demonstration of understanding, using specific questions to verify understanding, using response solicitations and monitoring patients' verbal and non-verbal responses. These strategies are illustrated with relevant data extracts. Interviews revealed that patients appeared to have good understanding of ARV-related concepts.

Conclusion: These strategies for verification of patient understanding appear to be effective tools which enable pharmacists to identify misunderstandings or initiate clarification sequences.

Practice implications: The strategies are felt to be particularly useful in cross-linguistic pharmacy interactions and have implications for other professionals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Communication Barriers
  • Comprehension
  • Cultural Competency*
  • Female
  • Humans
  • Male
  • Medication Adherence*
  • Middle Aged
  • Patient Education as Topic*
  • Pharmaceutical Services
  • Professional-Patient Relations*
  • South Africa


  • Anti-HIV Agents