Fine-grained Alignment of Large Language Models for General Medication Recommendation without Overprescription

Abstract

Large language models (LLMs) holds significant promise in achieving general medication recommendation systems owing to their comprehensive interpretation of clinical notes and flexibility to medication encoding. We evaluated both general-purpose and medical-specific LLMs for medication recommendations, showing their unsatisfactory precision and severe overprescription. To address this, we introduce Language-Assisted Medication Recommendation, which tailors LLMs for medication recommendation in a medication-aware manner, improving the usage of clinical notes. Fine-tuning LLMs with this framework can outperform existing methods by more than 10% in internal validation and generalize across temporal and external validations. Furthermore, the model maintains high accuracy when encountering out-of-distribution medication.