Generative AI for Medication Counselling and Adherence in Community Pharmacies

Human-AI Collaboration in the Pharmacy: A Cluster Randomized Controlled Trial of Generative AI for Medication Counselling and Adherence

Medication counseling within community pharmacies is crucial for managing chronic diseases, yet significant challenges regarding correctness and completeness remain in Jordan. Although generative artificial intelligence (AI) can be utilized for patient education, there is a lack of research on clinical impact and safety of AI in medication counseling conducted by pharmacists in real-world practice. The aim of this study is to evaluate the effect of pharmacist-supervised AI-assisted medication counseling on the correctness and completeness of counseling information and 30-day medication adherence among patients in Jordanian community pharmacies.

Materials and Methods: This pragmatic, two-arm cluster randomized controlled trial enrolled 136 adult patients across 16 community pharmacies in Jordan (8 clusters per arm). Pharmacists in the intervention arm used a standardized prompt strategy with ChatGPT® to generate counseling drafts, which were then verified and edited before delivery. The control arm provided usual counseling. Co-primary outcomes were correctness and completeness of counseling information (percentage scores based on blinded transcript analysis). Secondary outcomes included 30-day medication adherence (General Medication Adherence Scale [GMAS]), immediate patient understanding, and satisfaction. Data were analyzed using mixed-effects linear and logistic regression models.

Patient Eligibility Criteria

Inclusion Criteria:

Adults aged 18 years or older. Presenting with a new prescription or a refill for a chronic medication requiring counseling within one of the following classes: antihypertensives, oral antidiabetics, lipid-lowering agents, anticoagulants, or inhaled maintenance therapies.

Willing and able to provide informed consent.

Exclusion Criteria:

Presence of acute infections. Diagnosis of psychiatric disorders or oncological conditions. Presence of severe acute illness requiring urgent medical referral. Cognitive impairment precluding informed consent. Hearing or communication barriers that prevent interview completion without the presence of a caregiver.

Inability to provide a follow-up phone number for the 30-day adherence assessment.

Pharmacy and Pharmacist (Cluster) Eligibility Criteria

Inclusion Criteria:

Pharmacies legally registered in Jordan, providing routine prescription dispensing services, having at least one licensed pharmacist available during recruitment hours, and agreeing to participate for the full trial period.

Licensed pharmacists with a minimum of 2 years of clinical experience, working in participating pharmacies, providing direct patient counseling, and consenting to take part in the study.

Exclusion Criteria:

Pharmacies that are already using structured AI-assisted counseling tools as part of their routine practice.

Pharmacists on temporary placement for less than one month. Pharmacists not involved in patient-facing counseling.