Poor medication adherence undermines the control of chronic diseases. Community pharmacists can deliver structured counselling to improve it. This study evaluated the impact of pharmacist-led counselling on medication adherence in patients with type 2 diabetes, hypertension or bronchial asthma in Palwancha, Telangana. Methods: A prospective, pre-post interventional study enrolled 150 chronic-disease patients across five community pharmacies. Adherence was measured with the validated 8-item Morisky Medication Adherence Scale (MMAS-8) at baseline, one month and three months after a diseasespecific counselling intervention. Satisfaction was assessed with the PSQ-15. Paired t-tests and the McNemar test were used (p<0.05). Results: At baseline, 68.7% had low adherence (MMAS-8 <=5; mean 4.68 +/- 1.42) and baseline counselling quality was poor (composite score 32.5%). After intervention, low adherence fell to 38.7% at one month and 24.0% at three months (McNemar p<0.001), and mean MMAS-8 rose to 6.87 +/- 1.05 (+2.19; paired t-test p<0.001). Improvement was greatest in diabetes (+2.48). Satisfaction was high (82.7% good/excellent) and correlated with adherence gain (r=0.52, p<0.001).Conclusion: Structured community-pharmacist counselling significantly improved medication adherence across three chronic diseases, supporting its institutionalisation in community-pharmacy practice