The medicine may be right, but can the patient understand the instructions?

Imagine an elderly woman returning home from the hospital with medicines for hypertension. Before taking them, she opens the package and reads the information leaflet.

Soon, she encounters unfamiliar medical terms, long sentences and instructions she cannot follow. After several attempts, she sets the leaflet aside, hoping she remembers the pharmacist’s advice.

This raises a troubling question: What happens when patients receive the right medicines but cannot understand the information accompanying them?

For people living with hypertension, the question matters. The condition remains a significant public health concern in Ghana (Bosu et al., 2019). Medicines are essential, but patients must also understand how to use them safely.

The Language Behind the Prescription

Every medicine comes with information about dosage, side effects, precautions and when to seek medical attention. Patient Information Leaflets (PILs) are intended to provide this guidance.

However, providing information does not guarantee understanding. Raynor et al. (2006) stress the importance of making written medicine information meaningful to patients.

This concern informed study of the language used in leaflets for three antihypertensive medicines: Methyldopa, Zestoretic and Telmisartan. We examined how their wording communicates instructions and shapes the relationship between healthcare institutions and patients.

What The Research Found

The analysis focused on two linguistic features: telic and atelic expressions.

Telic expressions describe actions with a clear goal or endpoint, such as “Contact your doctor immediately.” Atelic expressions describe ongoing activities or situations without a definite endpoint, such as “You may feel drowsy or light-headed” (Comrie, 1976).

Both have a place in medical communication, but the distinction matters when patients must decide what to do.

Atelic expressions appeared more often than telic expressions in all three leaflets. Methyldopa contained 34.6% atelic and 25.9% telic expressions. Zestoretic contained 36.9% and 22.6%, respectively, while Telmisartan contained 37.5% and 20.5%.

These figures suggest that the leaflets emphasise ongoing treatment routines and descriptions of medical conditions. Such information is useful, but patients also need clear guidance.

For example, a leaflet may warn that a medicine can cause dizziness. But what should a patient do if the dizziness becomes severe? Clear, practical instructions are essential.

When Medical Authority Meets Patient Understanding

The issue also involves the power of language

Healthcare professionals possess specialised knowledge, and their instructions are vital to safe treatment. Yet patients should not be treated as passive recipients of medical decisions. Van Dijk (2006) explains how language can reflect and reinforce power relationships.

Consider the instruction: “Do not stop taking Methyldopa without talking to your doctor.” This is an important precaution, but explaining why it matters can help patients understand their responsibilities.

The goal is not to weaken professional authority. It is to communicate medical expertise in ways patients can understand. Patients have questions, concerns and experiences that deserve attention.

Making Every Instruction Count

What lessons can Ghana’s healthcare system draw from these findings?

First, pharmaceutical companies should make leaflets easier to read without sacrificing accuracy.

Second, healthcare professionals should explain key instructions in language patients understand. In Ghana’s multilingual society, this may include familiar Ghanaian languages.

Third, patients should be encouraged to seek clarification when they are uncertain about their medicines.

Health literacy is an important public health concern (Nutbeam, 2000), and research links it to health outcomes (Berkman et al., 2011).

The study examined three leaflets rather than patients’ experiences. Further research is needed to determine how these language patterns affect understanding and medicine use.

Beyond the Prescription

Healthcare responsibility does not end when a doctor writes a prescription or a pharmacist dispenses medication. It also includes ensuring that patients understand how to use their medicines safely.

A leaflet may be medically accurate and professionally written. If its intended reader cannot understand it, however, a communication gap remains.

Perhaps we should ask not only whether patients received their medicines, but whether they understand what they were told about them.

In healthcare, what is communicated matters. How it is understood matters just as much.

References

Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low health literacy and health outcomes. Annals of Internal Medicine, 155(2), 97–107.

Bosu, W. K., Reilly, S. T., Aheto, J. M. K., & Zucchelli, E. (2019). Hypertension in Ghana. PLOS ONE, 14(3), e0213607.

Comrie, B. (1976). Aspect. Cambridge University Press.

Nutbeam, D. (2000). Health literacy as a public health goal. Health Promotion International, 15(3), 259–267.

Raynor, D. K., Knapp, P., & Silcock, J. (2006). Helping patients make sense of written medicines information. Patient Education and Counseling, 64(1–3), 175–181.

van Dijk, T. A. (2006). Discourse and manipulation. Discourse & Society, 17(3), 359–383.

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