Advancing Medication Safety in the Real World: Multidisciplinary Strategies for Preventing Harm and Improving Outcomes

Medication safety remains one of the greatest challenges in healthcare worldwide. Despite advances in clinical practice, digital health, and pharmacovigilance, avoidable medication-related harm continues to impact patient outcomes across hospitals, aged care, primary care, and community settings. While pharmacoepidemiology provides valuable insights into drug utilization patterns and outcomes at the population level, medication safety research is uniquely positioned to examine the preventability of harm, the systems and human factors that contribute to errors, and the interventions and policies required to mitigate risk. This research aims to carve out medication safety as a distinct academic focus by investigating not just the what of medication-related harm, but the how and why through a lens of healthcare systems, decision-making frameworks, and policy-level strategies, aligned with the WHO Global Patient Safety Challenge: Medication Without Harm.
We invite contributions spanning multiple professions such as pharmacy, medicine, nursing, public health, informatics and from different health system contexts, including low- and middle-income countries where challenges and opportunities may differ.

This collection welcomes studies on (but not limited to):

1. Identifying and Preventing Harm

• Medication-related hospitalisations, adverse drug reactions, falls, high-risk medicines, PIM/PPO and polypharmacy.
• Measurement tools and criteria (e.g., STOPP/START, Beers, anticholinergic burden, MAI) and novel frameworks.
• Real-world evidence: pharmacoepidemiology, risk stratification and predictive modelling.

2. Systems-Level Interventions
• Medication reconciliation, deprescribing programs, transitions-of-care bundles and multidisciplinary models.
• Digital solutions: clinical decision support, e-prescribing, interoperability, AI/ML early-warning systems.
• Patient–clinician partnerships and co-design to reduce harm and improve experience.

3. Decision-Making and Human Factors
• How clinicians perceive and manage medication-related risk.
• Safety culture, interprofessional collaboration, and behavioural influences on prescribing and deprescribing.
• Training and education to enhance medication safety capacity.

4. Policy, Implementation and Global Perspectives
• Governance models, policies and scope-of-practice enabling safer medicines use.
• Implementation science: adoption, fidelity, equity, scale-up, sustainability and cost-effectiveness.
• Comparative perspectives across high-, middle-, and low-income countries.

We invite submissions in various formats, including original research (observational studies, RCTs, pharmacoepidemiology), reviews (systematic, scoping, narrative), brief reports on innovative interventions or QI projects, policy papers and perspectives, implementation case studies addressing these key themes.

We prioritise real-world evidence derived from routine care linked administrative data, EHRs, registries, pharmacy claims, pragmatic and hybrid effectiveness-implementation trials, to inform practice and policy. Suitable methods include target-trial emulation, propensity/weighting approaches, interrupted time series, difference-in-differences, stepped-wedge designs, data linkage/federated analyses and use of common data models (e.g., OMOP). We encourage best-practice reporting (STROBE/RECORD, CONSORT-Pragmatic, TIDieR, CHEERS) and equity reporting (e.g., PROGRESS-Plus). We will not consider studies that rely solely on spontaneous/self-reported adverse event databases (e.g., FAERS, EudraVigilance, VigiBase) without appropriate validation, denominator data, or complementary real-world data sources (e.g., EHRs, linked claims, registries) and robust causal/analytic methods.

Keywords: Medication safety, preventable harm; deprescribing, polypharmacy, inappropriate prescribing, clinical decision support, pharmacoepidemiology, real-world evidence (RWE), implementation science, human factors, patient safety, health policy, WHO Medication

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.