Impact of AI-Based Medication Reminder Systems on Medication Adherence Among Patients with Chronic Diseases: A Community Pharmacy Perspective

Roughly half of patients with chronic diseases do not take their medicines as prescribed. In India, a nationally representative WHO-SAGE analysis found only about 51% of adults with non-communicable diseases are adherent. Community pharmacies are the most frequent point of contact for these patients, and artificial intelligence (AI) is increasingly being added to medication reminders through adaptive messaging, conversational agents, computer-vision dose confirmation and machine-learning risk prediction. This study examined, using published secondary data, (i) the effect of AI-based reminder and support systems on medication adherence in chronic disease; (ii) how that effect compares with conventional digital reminders and pharmacist-led care; and (iii) what the evidence implies for community pharmacy practice in India. A structured review of secondary data was undertaken in which sixteen documents were analysed—five primary studies, eight systematic, focused or narrative reviews and meta-analyses, one trial protocol and two policy/normative documents—together with five further AI trials extracted from those reviews; outcomes were tabulated as absolute adherence differences, odds ratios or standardised mean differences and synthesised narratively. Small AI trials reported large gains (e.g., plasma-confirmed adherence 100% vs 50% with an AI video-confirmation app; insulin adherence +32.7 percentage points with a voice assistant). The only meta-analysis of AI interventions found a moderate pooled effect (Hedges g = 0.41; 95% CI 0.17–0.65; 7 studies, 934 participants) but rated certainty as low, with a prediction interval crossing zero. The largest AI study (>33,000 patients) showed a modest 6.1% improvement. Conventional SMS reminders roughly doubled the odds of adherence (OR 2.11), whereas passive reminder devices and stand-alone apps produced little or no change, and pharmacist-led interventions improved adherence in 69% of trials. Overall, AI-based reminders are promising but not yet proven to outperform well-designed non-AI reminders. Their greatest value in community pharmacies is likely to come from combining risk prediction with pharmacist follow-up, rather than from automated reminders alone, and a rigorous Indian community pharmacy trial is needed.