Written by James Anderson
Published on Vol 6 Issue 1, 2026
Medication appropriateness is an important component of medicines management, but multimorbidity creates therapeutic decisions in which a medication can be indication-concordant yet still be poorly aligned with the patient’s overall clinical situation. Disease-specific benefit, treatment burden, practical workability, and patient priorities may diverge, change over time, or operate at different levels of care. To develop an evidence-bounded conceptual model of therapeutic optimization that treat
Written by Hans Müller
Published on Vol 6 Issue 1, 2026
Precision dosing increasingly combines pharmacokinetic models, organ-function estimates, therapeutic drug monitoring, pharmacogenomic information, and exposure–response evidence. Yet the availability of more patient-specific data does not ensure that a safer or more defensible dose decision can be made. This Current Opinion argues that precision dosing should prioritize actionability before data abundance. Actionability is defined here as the extent to which a dosing signal is sufficiently relia
Written by Sofía Martínez
Published on Vol 6 Issue 1, 2026
Pharmacogenomic results are often represented as durable patient attributes: a genotype is translated into a predicted phenotype, linked to a prescribing recommendation, and stored for future use. This representation captures the persistence of genomic information but can obscure the conditional nature of clinical actionability. Drug exposure, enzyme inhibition, polypharmacy, competing therapeutic priorities, guideline methodology, and the practical capacity to act can change while genotype rema
Written by Kenji Tanaka
Published on Vol 6 Issue 1, 2026
Deprescribing is often described as the planned reduction or discontinuation of medicines whose harms, treatment burden, or limited expected benefit no longer justify continued use. That definition is necessary but incomplete for complex polypharmacy because a safe medication change does not end when a prescription is stopped. The clinical consequences of withdrawal depend on which medicine is changed first, what other medicines and conditions remain, whether symptoms represent withdrawal or rec
Written by João Silva
Published on Vol 6 Issue 1, 2026
Medication-related clinical decision support is commonly judged through alert counts, override rates, acceptance rates, or rule-level technical performance. These measures describe system activity but do not directly establish whether preventable medication harm has been reduced. This Current Opinion argues that medication-safety signals should instead be assigned to response modes according to the combination of potential harm, immediacy, contextual uncertainty, persistence, interpretive requir
Written by Emma Wilson
Published on Vol 6 Issue 1, 2026
Generative artificial intelligence is increasingly being evaluated for medication information, clinical-pharmacy questions, treatment recommendations, deprescribing, documentation, and other pharmacotherapy tasks. Its apparent efficiency can obscure a medication-safety problem: fluent output may be difficult to audit, expensive to verify, insensitive to changing patient context, or persuasive even when wrong. This Current Opinion argues that the clinically relevant boundary is not whether a mode
Written by Mark Anderson
Published on Vol 6 Issue 1, 2026
Antimicrobial stewardship is often judged at the moment an antibiotic is selected: whether empirical coverage accords with guidance, whether the organism is susceptible, and whether therapy appears microbiologically appropriate. Yet treatment success and avoidable antimicrobial exposure are determined by a sequence of decisions that continues after initial prescribing. Diagnostic information becomes progressively more specific; pharmacokinetic and pharmacodynamic conditions may alter achieved ex
Written by Sara Al-Fahd
Published on Vol 6 Issue 1, 2026
Medication reconciliation is central to safer transitions of care, yet an accurate discharge medication list does not ensure that intended medication changes remain understood, accessible, feasible, or clinically appropriate after discharge. To distinguish medication reconciliation from medication continuity and propose a pharmacist-led framework linking therapeutic intent, information transfer, patient capability, and post-discharge follow-up. This non-empirical model integrates evidence from t
Written by Youssef Hariri
Published on Vol 6 Issue 1, 2026
Medication nonadherence is commonly managed as if one problem could be corrected by one broadly applicable adherence intervention. This paper develops a methodological approach for matching pharmacy-practice interventions to the medication-taking process that has failed, while separately considering treatment burden, patient capability, access constraints, and implementation feasibility. An evidence-bounded conceptual development process was used. Established distinctions among initiation, imple
Written by David Osei
Published on Vol 6 Issue 1, 2026
Renal dose adjustment is commonly operationalized by assigning a patient to a kidney-function category and applying a corresponding dosing recommendation. This approach is practical when renal function is relatively stable, but it becomes increasingly fragile when estimated filtration, acute kidney injury trajectories, extracorporeal clearance, measured drug exposure, and clinical response evolve on different timescales or point toward different dosing decisions. This Current Opinion argues that
Written by Kristian Eriksen
Published on Vol 6 Issue 1, 2026
Precision pharmacotherapy seeks to improve treatment selection and dosing by matching therapy more closely to biological characteristics, drug response, and individual risk. Yet biological appropriateness does not ensure that a patient can obtain, understand, monitor, sustain, or replace the recommended treatment. This Perspective argues that clinical pharmacology therefore requires a complementary concept of pharmacoequity: the condition in which biologically appropriate therapy can plausibly b
Written by Mikko Lahtinen
Published on Vol 6 Issue 1, 2026
Medication-safety programs commonly identify medicines, classes, interactions, or prescribing situations associated with elevated harm. These approaches are clinically useful, but a medicine categorized as high risk does not confer a constant probability of harm across patients, settings, or time. This Current Opinion argues that medication-harm prevention requires a more explicitly patient-level and dynamic interpretation of risk. Intrinsic and regimen-dependent drug hazard should be considered
Written by Omar Zayed
Published on Vol 6 Issue 1, 2026
Formulary coverage is commonly treated as a practical endpoint of pharmacotherapy allocation, yet coverage alone does not establish comparative clinical benefit, acceptable treatment burden, preference concordance, affordability, or feasible treatment use. This analysis develops an evidence-bounded framework for distinguishing these domains and reconciling them without reducing patient value to a single coverage or economic signal. A targeted conceptual health-policy analysis was conducted acros
Written by Wei Zhang
Published on Vol 6 Issue 1, 2026
Drug-related problems (DRPs) differ not only in clinical importance but also in how quickly harm may occur, how many variables must be integrated, how much information is missing, how modifiable the problem is, and whether pharmacist effort is likely to generate meaningful value. This paper develops a risk-based method for differentiating pharmacist responses after a DRP has been recognised. A structured conceptual-development approach was used. Contemporary evidence on pharmacist prioritisation
Written by Rafael Mendoza
Published on Vol 6 Issue 1, 2026
Pharmacist-led medication optimization is increasingly used to address polypharmacy, potentially inappropriate prescribing, and medication-related risk in older people with multimorbidity. However, improvement in medication-related indicators does not necessarily translate into fewer hospitalizations, lower mortality, fewer falls, better function, or improved quality of life. To determine when pharmacist-led medication optimization is associated with improved outcomes by distinguishing intervent
Written by Wouter De Smet
Published on Vol 6 Issue 1, 2026
Pharmacogenomic testing can identify clinically relevant gene–drug variation, but its value in pharmacy practice depends on whether results are converted into interpretable and timely prescribing decisions. Implementation therefore extends beyond laboratory testing to result delivery, decision support, professional interpretation, workflow integration, and continuity across care settings. To map how pharmacogenomic testing was integrated into prescribing workflows across pharmacy practice settin
Written by Ana Rodrigues
Published on Vol 6 Issue 1, 2026
Deprescribing is commonly judged by whether medicines are stopped, doses are reduced, or potentially inappropriate prescribing declines. These outcomes demonstrate medication change but do not necessarily establish that an older adult is clinically safer, functions better, experiences less treatment burden, or regards the intervention as beneficial. This umbrella review examines systematic reviews and meta-analyses published between 2017 and 2026 to determine what constitutes successful deprescr
Written by Krzysztof Wiśniewski
Published on Vol 6 Issue 1, 2026
Pharmacist-led transitions-of-care interventions can improve medication processes, yet effects on downstream utilization and sustainability vary across settings and patient groups. Conventional intervention labels do not adequately explain why apparently similar services produce different outcomes. To develop and refine a realist programme theory explaining how patient complexity, interprofessional integration, information continuity, patient capability, and organizational capacity condition mec
Written by Ahmed Ben Ali
Published on Vol 6 Issue 1, 2026
Artificial intelligence is increasingly used to prioritize prescriptions, suppress low-value alerts, identify medication-error risk, and support pharmacist verification. However, technical detection performance is frequently discussed alongside workflow or patient outcomes as though these endpoints demonstrate equivalent clinical value. This evidence-mapping review examines where AI-assisted medication review has progressed beyond technical screening and where evidence remains limited across aut
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