AI-Assisted Personalized Heat-Risk Alerts

This two-arm randomized controlled trial will evaluate whether an artificial intelligence-assisted personalized heat-risk alert system reduces heat-related illness symptom burden among adults with chronic conditions. The intervention will integrate prespecified clinical characteristics with the Pakistan Meteorological Department's same-day forecast maximum temperature to classify individual heat-related acute clinical-event risk and deliver personalized alerts through a mobile application. The control group will receive a generic PMD heat-health advisory through the same application.

Inclusion Criteria: * Adults aged 18 years or older attending the outpatient department of the selected tertiary-care hospital during the recruitment period. * Have a documented diagnosis of at least one chronic non-communicable disease associated with increased susceptibility to heat-related illness, including hypertension, type 2 diabetes mellitus, chronic kidney disease, cardiovascular disease, or obesity (BMI ≥30 kg/m²). * Have access to a personal smartphone capable of receiving study heat-risk alert notifications. * Be able to read Urdu or English, or have a household member/caregiver available to read and explain study alerts when required. * Be willing and able to provide written informed consent. * Intend to remain within the study catchment area for the duration of the six-week study period to facilitate follow-up. Exclusion Criteria: * Patients requiring immediate emergency treatment or hospital admission at the time of recruitment. * Individuals with severe cognitive impairment, dementia, psychotic illness, or another medical condition that limits their ability to understand study procedures or provide informed consent. * Patients with terminal illness or those receiving palliative care. * Individuals with severe visual, hearing, or communication impairments that prevent effective receipt of the study alert intervention and outcome assessment without a reliable caregiver. * Pregnant women, because pregnancy has distinct physiological responses to heat exposure and would require separate clinical risk stratification beyond the scope of this study. * Participants currently enrolled in another clinical trial or structured behavioral intervention related to heat-health, climate adaptation, or chronic disease self-management. * Participants who are unable or unwilling to comply with study procedures or complete the required follow-up assessment.