# PACE-RAG: Patient-Aware Contextual and Evidence-Constrained RAG for Clinical Drug Recommendation

arXiv: https://arxiv.org/abs/2603.17356 · HTML: https://mlsanity.com/paper/2603.17356/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 15 of its 44 references that are in the map.
- First posted on arXiv 18 Mar 2026.

## Builds on (most cited first, 15 of 15)

- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [Self-RAG: Learning to Retrieve, Generate, and Critique through Self-Reflection](https://mlsanity.com/paper/2310.11511/) (2023)
- [Large Language Models Encode Clinical Knowledge](https://mlsanity.com/paper/2212.13138/) (2022)
- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [Benchmarking Retrieval-Augmented Generation for Medicine](https://mlsanity.com/paper/2402.13178/) (2024)
- [MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning](https://mlsanity.com/paper/2311.10537/) (2023)
- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (2024)
- [Stream of Search (SoS): Learning to Search in Language](https://mlsanity.com/paper/2404.03683/) (2024)
- [MedRAG: Enhancing Retrieval-augmented Generation with Knowledge Graph-Elicited Reasoning for Healthcare Copilot](https://mlsanity.com/paper/2502.04413/) (2025)
- [Apollo: A Lightweight Multilingual Medical LLM towards Democratizing Medical AI to 6B People](https://mlsanity.com/paper/2403.03640/) (2024)
- [Conditional Generation Net for Medication Recommendation](https://mlsanity.com/paper/2202.06588/) (2022)
- [Large Language Model Distilling Medication Recommendation Model](https://mlsanity.com/paper/2402.02803/) (2024)
- [ReflectEvo: Improving Meta Introspection of Small LLMs by Learning Self-Reflection](https://mlsanity.com/paper/2505.16475/) (2025)
- [MedReflect: Teaching Medical LLMs to Self-Improve via Reflective Correction](https://mlsanity.com/paper/2510.03687/) (2025)
- [MED-COPILOT: A Medical Assistant Powered by GraphRAG and Similar Patient Case Retrieval](https://mlsanity.com/paper/2603.00460/) (2026)

## Built on by (most cited first, 1 of 1)

- [ARMED: Adaptive Retrieval-Augmented Medication Recommendation](https://mlsanity.com/paper/2610.16440/) (2026)

## Abstract (arXiv)

Drug recommendation requires a deep understanding of individual patient context, especially for complex conditions like Parkinson's disease. While LLMs possess broad medical knowledge, they fail to capture the subtle nuances of actual prescribing patterns. Existing RAG methods also struggle with these complexities because guideline-based retrieval remains too generic and similar-patient retrieval often replicates majority patterns without accounting for the unique clinical nuances of individual patients. To bridge this gap, we propose PACE-RAG (Patient-Aware Contextual and Evidence-Constrained RAG). Rather than directly copying frequent medications from retrieved patients, PACE-RAG personalizes recommendations by first extracting patient-specific clinical features, retrieving cases around these features, and then refining the final prescription using the patient's current symptoms, active medication history, and focus-specific prescribing tendencies. By analyzing treatment patterns tailored to specific clinical features, PACE-RAG generates patient-specific medication recommendations along with an explainable clinical summary. PACE-RAG achieved the strongest performance among the evaluated inference-only LLM-based methods, reaching F1 scores of 80.84% and 47.22% on the Parkinson's disease and MIMIC-IV cohorts, respectively. Our code is available at: https://github.com/ChaeYoungHuh/PACE-RAG.