Advances in Clinical Pharmacy: From Clinical Trials to Patient Safety

Dear Colleagues,

Advances in clinical pharmacy and clinical trials are increasingly central to modern healthcare systems, as the safe and effective use of medications remains a cornerstone of patient care. Rapid scientific progress in drug development, coupled with the growing complexity of therapeutic regimens, has heightened the need for integrated approaches that encompass clinical trials, pharmacovigilance, experimental pharmacology, and toxicology. Globally, healthcare systems are facing significant challenges, including aging populations, the rising prevalence of chronic diseases, polypharmacy, and increasing healthcare costs. These trends place clinical pharmacists at the forefront of optimizing pharmacotherapy, minimizing adverse drug reactions, and ensuring patient safety across diverse clinical settings, including pediatric and rare disease populations where therapeutic evidence is often limited.

At the same time, the expansion of precision medicine, pharmacogenomics, and real-world evidence is creating new opportunities to individualize treatment and improve outcomes. Advances in clinical trials, particularly adaptive designs, decentralized trials, and the use of digital health technologies, are reshaping how evidence is generated and applied in practice. However, these innovations also introduce challenges related to data integration, regulatory oversight, and the translation of findings into routine care. Toxicological considerations remain critical, as drug-related harm continues to be a major cause of morbidity and mortality worldwide. Understanding the interplay between pharmacokinetics, pharmacodynamics, and patient-specific factors is essential for mitigating risks and enhancing therapeutic efficacy.

Pharmacovigilance has become an essential pillar of contemporary healthcare and drug development, ensuring the continuous monitoring, detection, assessment, and prevention of adverse drug reactions throughout the lifecycle of medicinal products. The growing availability of large-scale healthcare databases, artificial intelligence tools, and real-world evidence is transforming pharmacovigilance practices and enabling the earlier identification of safety signals. Paying close attention to vulnerable populations is increasingly required, particularly for children and patients with rare diseases, who are frequently underrepresented in clinical trials and may experience unique therapeutic challenges.

This Special Issue will present and disseminate the most recent advances related to clinical trials, pharmacovigilance, pharmacology, and toxicology within the fields of experimental and clinical pharmacy, with particular emphasis on patient safety. We consider contributions addressing the discovery, evaluation, and optimization of drug therapies; innovative clinical trial methodologies; mechanisms of drug toxicity; pharmacovigilance systems and safety monitoring; pediatric pharmacotherapy; and strategies to prevent adverse drug events. Submissions that bridge basic science and clinical application, as well as those that incorporate real-world data, digital health tools, and interdisciplinary approaches, are particularly encouraged.

Topics of interest for publication include, but are not limited to, the following:

1. Innovative designs and methodologies in clinical trials;
2. Clinical pharmacology and therapeutic drug monitoring;
3. New approaches in treatment of common diseases and symptoms;
4. Polypharmacy management and medication safety in vulnerable populations;
5. Integration of digital health technologies in clinical pharmacy practice;
6. Strategies to improve patient adherence and therapeutic outcomes;
7. Advances in pharmacovigilance and drug safety monitoring systems;
8. Real-world evidence and artificial intelligence applications in pharmacovigilance;
9. Pediatric clinical trials and age-appropriate drug formulations;
10. Mechanisms and prevention of drug toxicity and adverse drug reactions;
11. Pharmacogenomics and personalized medicine in clinical pharmacy;
12. The role of inflammation and oxidative stress in disease and pharmacotherapy.

Dr. Radiana Staynova
Dr. Elisaveta Georgieva Apostolova
Dr. Vesela Kokova
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• decentralized clinical trials
• patient safety
• adverse drug reactions
• clinical pharmacy
• pharmacotherapy
• polypharmacy optimization
• real world evidence
• pharmacovigilance AI