at that time were related to the extremely poor level of patient knowledge and understanding. Less than one in five patients understood what drug they were to take and how to take it. Similar results were found in other Brazilian cities such as Campo Grande, Salvador, Ribeirao Preto, and Fortaleza. As noted in the study, this low level of information can have serious consequences regarding the effectiveness and efficiency of the investment in essential drugs. Silva et al in another study cited in this study reported that, after outpatient visits in Rio Grande do Sul, only 34% had good knowledge regarding the drugs obtained. According to Fletcher, the term compliance refers to the degree in which patients follow the prescribed medical advice. Although initial analysis indicates that noncompliance to prescribed actions might suggest negligence or unwillingness to submit to medical advice, the study rightly notes that in fact many factors may contribute to that such as inadequate knowledge or prescription understanding. That, in turn, may be related to factors such as short visit and dispensing times, no pharmaceutical care practices in place, no pharmacy-generated labelling at the time of prescription, high frequency of illegible prescriptions, illiteracy, poorly trained workers performing the task of drug dispensing and low population schooling. Again, as suggested in my blog, this calls for strengthening processes and systems, including the adoption of clinical guidelines tied to funding allocations to the facilities or teams (an incentive to promote rational use of drugs). --The study concludes by stating