AI-enabled digital therapeutics in pharmacy practice: prescription software, medication optimization, safety surveillance, and future clinical positioning

INTRODUCTION: Digital therapeutics (DTx) are evidence-based software interventions that can function as therapeutic modalities, either independently or adjunctively, while artificial intelligence (AI) may support personalization, prediction, adaptive delivery, and safety monitoring. Pharmacy practice is directly affected because pharmacists manage medicines, adherence, counseling, pharmacovigilance, access, and longitudinal medication-related care. AREAS COVERED: This structured narrative review defines digital health, digital medicine, DTx, prescription DTx (PDT), software as a medical device (SaMD), and AI-enabled DTx; critically examines clinical evidence and its limitations; and evaluates pharmacist roles in product selection, onboarding, monitoring, medication optimization, safety surveillance, reimbursement, and governance. PubMed and targeted regulatory and professional sources were searched through July 2026, with priority given to randomized trials, systematic reviews, meta-analyses, real-world evidence frameworks, and official guidance. EXPERT OPINION: AI-enabled DTx should be regarded as therapeutic modalities whose role may be standalone or adjunctive according to intended use and evidence. They are distinct from pharmacological medicines, and they should not autonomously displace indicated drug therapy or professional judgment without comparative evidence. Pharmacist-supervised integration is proposed as a clinically accountable conceptual implementation model, but its effectiveness, cost-effectiveness, and workflow consequences require prospective validation.