# Medication counseling with large language models: balancing flexibility and rigidity

arXiv: https://arxiv.org/abs/2601.11544 · HTML: https://mlsanity.com/paper/2601.11544/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 18 of its 44 references that are in the map.
- First posted on arXiv 2 Dec 2025.

## Builds on (most cited first, 18 of 18)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [ReAct: Synergizing Reasoning and Acting in Language Models](https://mlsanity.com/paper/2210.03629/) (2022)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Lost in the Middle: How Language Models Use Long Contexts](https://mlsanity.com/paper/2307.03172/) (2023)
- [Sparks of Artificial General Intelligence: Early experiments with GPT-4](https://mlsanity.com/paper/2303.12712/) (2023)
- [Survey of Hallucination in Natural Language Generation](https://mlsanity.com/paper/2202.03629/) (2022)
- [A Survey on Hallucination in Large Language Models: Principles, Taxonomy, Challenges, and Open Questions](https://mlsanity.com/paper/2311.05232/) (2023)
- [BARTScore: Evaluating Generated Text as Text Generation](https://mlsanity.com/paper/2106.11520/) (2021)
- [Decomposed Prompting: A Modular Approach for Solving Complex Tasks](https://mlsanity.com/paper/2210.02406/) (2022)
- [Long-context LLMs Struggle with Long In-context Learning](https://mlsanity.com/paper/2404.02060/) (2024)
- [EASYTOOL: Enhancing LLM-based Agents with Concise Tool Instruction](https://mlsanity.com/paper/2401.06201/) (2024)
- [LLM-based NLG Evaluation: Current Status and Challenges](https://mlsanity.com/paper/2402.01383/) (2024)
- [The Three Ghosts of Medical AI: Can the Black-Box Present Deliver?](https://mlsanity.com/paper/2012.06000/) (2020)
- [Inherent and emergent liability issues in LLM-based agentic systems: a principal-agent perspective](https://mlsanity.com/paper/2504.03255/) (2025)
- [A review of faithfulness metrics for hallucination assessment in Large Language Models](https://mlsanity.com/paper/2501.00269/) (2024)
- [Rx Strategist: Prescription Verification using LLM Agents System](https://mlsanity.com/paper/2409.03440/) (2024)
- [Using role-play and Hierarchical Task Analysis for designing human-robot interaction](https://mlsanity.com/paper/2509.13378/) (2025)

## Abstract (arXiv)

The introduction of large language models (LLMs) has greatly enhanced the capabilities of software agents. Instead of relying on rule-based interactions, agents can now interact in flexible ways akin to humans. However, this flexibility quickly becomes a problem in fields where errors can be disastrous, such as in a pharmacy context, but the opposite also holds true; a system that is too inflexible will also lead to errors, as it can become too rigid to handle situations that are not accounted for. Work using LLMs in a pharmacy context have adopted a wide scope, accounting for many different medications in brief interactions -- our strategy is the opposite: focus on a more narrow and long task. This not only enables a greater understanding of the task at hand, but also provides insight into what challenges are present in an interaction of longer nature. The main challenge, however, remains the same for a narrow and wide system: it needs to strike a balance between adherence to conversational requirements and flexibility. In an effort to strike such a balance, we present a prototype system meant to provide medication counseling while juggling these two extremes. We also cover our design in constructing such a system, with a focus on methods aiming to fulfill conversation requirements, reduce hallucinations and promote high-quality responses. The methods used have the potential to increase the determinism of the system, while simultaneously not removing the dynamic conversational abilities granted by the usage of LLMs. However, a great deal of work remains ahead, and the development of this kind of system needs to involve continuous testing and a human-in-the-loop. It should also be evaluated outside of commonly used benchmarks for LLMs, as these do not adequately capture the complexities of this kind of conversational system.