Gen Z perceptions of AI-supported prescription fulfillment in community pharmacy

Abstract Background: Artificial intelligence (AI) is increasingly integrated into health care, including community pharmacy. While members of Generation Z (Gen Z) are early adopters of AI in academic settings, their acceptance of AI as pharmacy patients remains largely unexplored. Methods: A between-subjects experimental survey was conducted with a convenience sample of Gen Z university students ( n = 181), who were randomly assigned to 1 of 4 prescription fulfillment scenarios varying in AI involvement: No AI, Low AI (chatbot), Medium AI (background clinical support), or High AI (fully automated). Participants first reported their general attitudes toward AI in pharmacy, then evaluated their assigned scenario on satisfaction, trust in the pharmacist, and behavioural intentions. Results: Overall attitudes toward AI were neutral, with no differences across conditions. Scenario-based evaluations revealed that the No AI condition consistently outperformed AI conditions on satisfaction, trust, and behavioural intentions. Trust showed the largest effect (partial η² = .10), with Low AI outperforming Medium and High AI on several items. Discussion: The acceptance of AI by Gen Z participants as pharmacy patients was cautious: familiarity with AI did not translate into strong endorsement, and patient-facing AI tended to reduce satisfaction, trust, and loyalty. Findings suggest a threshold effect for satisfaction and behavioural intentions, but both threshold and gradient patterns for trust, with Low AI sometimes outperforming more automated models. Conclusion: These findings highlight the importance of human-in-the-loop AI implementation models, where AI supports rather than replaces pharmacist judgment, and reinforce the need for cautious, patient-informed AI implementation in community pharmacy.