Coupled Graph--Policy Distillation for Personalized Medication Safety in Older Adults with Multimorbidity
This work addresses medication safety risks faced by older adults with multimorbidity during non-clinical periods due to missed critical health information. It proposes ATLAS, a framework that constructs a medication safety knowledge graph and dynamically generates personalized drug interaction graphs based on patient states. ATLAS incorporates a risk-prioritized multi-agent strategy to perform contraindication screening, risk assessment, and alternative recommendation. The framework innovatively introduces a coupled graph-policy distillation mechanism to translate clinical guideline evidence into individualized decisions and establishes GeriMedBench—the first interactive benchmark for evaluating systems’ evidence-based decision-making capabilities. Experiments demonstrate that ATLAS significantly outperforms existing methods across multiple international benchmarks: on the European non-interactive multimorbidity test, it achieves a 53.73-point gain in Strict Success Rate and a 14.63-point improvement in OSRS over the strongest closed-source LLM baseline, with zero unsafe recommendations in automated evaluation and superior performance across all metrics in clinical double-blind assessment.