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  <front>
    <journal-meta>
      <journal-id journal-id-type="iso-abbrev">Arch Pharm Pract</journal-id>
      <journal-id journal-id-type="publisher-id">archivepp.com</journal-id>
      <journal-id journal-id-type="publisher-id">Arch Pharm Pract</journal-id>
      <journal-title-group>
        <journal-title>Archives of Pharmacy Practice</journal-title>
      </journal-title-group>
      <issn pub-type="epub">2320-5210</issn>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">archivepp.com-1254</article-id>
      <article-id pub-id-type="doi">10.51847/ROT7TCFRhD</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original research</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Artificial Intelligence as a Second Reader for High-Risk Prescriptions rather than a First Decision Maker</article-title>
      </title-group>
                    <contrib-group>
                      <contrib contrib-type="author">
              <name>
                <surname>Al-Fahd</surname>
                <given-names>Sara</given-names>
              </name>
                              <xref rid="aff1" ref-type="aff">1</xref>
                                                            <xref rid="cor1" ref-type="corresp" />
                          </contrib>
                      <contrib contrib-type="author">
              <name>
                <surname>Al-Khalifa</surname>
                <given-names>Noura</given-names>
              </name>
                              <xref rid="aff1" ref-type="aff">1</xref>
                                        </contrib>
                      <contrib contrib-type="author">
              <name>
                <surname>Al-Turki</surname>
                <given-names>Omar</given-names>
              </name>
                              <xref rid="aff2" ref-type="aff">2</xref>
                                        </contrib>
                  </contrib-group>
                  <aff id="aff1">
            <label>1</label>Department of High-Risk Prescription Safety, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
          </aff>
                  <aff id="aff2">
            <label>2</label>Department of AI-Assisted Clinical Review, College of Pharmacy, King Fahd University of Petroleum and Minerals, Dhahran, Saudi Arabia
          </aff>
                          <author-notes>
            <corresp id="cor1">
              <bold>Address for correspondence:</bold> Prof. Wael Abu Dayyih, Department of
              Pharmaceutical Chemistry, Faculty of Pharmacy, Mutah University, Al-Karak 61710, Jordan.
                              E-mail: <email xlink:href="s.alfahd@ksu.edu.sa">s.alfahd@ksu.edu.sa</email>
                          </corresp>
          </author-notes>
                    <pub-date pub-type="epub">
        <day>30</day>
        <month>06</month>
        <year>2025</year>
      </pub-date>
      <volume>16</volume>
      <issue>2</issue>
      <fpage>35</fpage>
      <lpage>43</lpage>
      <permissions>
        <copyright-statement>
          Copyright: &#x000a9; 2026 Archives of Pharmacy Practice
        </copyright-statement>
        <copyright-year>2026</copyright-year>
        <license>
          <ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/"
            specific-use="textmining" content-type="ccbyncsalicense">
            https://creativecommons.org/licenses/by-nc-sa/4.0/</ali:license_ref>
          <license-p>This is an open access journal, and articles are distributed under the terms of
            the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows
            others to remix, tweak, and build upon the work non-commercially, as long as appropriate
            credit is given and the new creations are licensed under the identical terms.</license-p>
        </license>
      </permissions>
      <abstract>
        <title>A<sc>BSTRACT</sc></title>
        <p>Artificial intelligence is increasingly positioned near medication decisions, yet the safest location for algorithmic assistance remains unresolved. Treating AI as the first reader may frame the case before a pharmacist has independently interpreted the prescription, while treating it as a decision maker may blur professional authority, encourage automation bias, and conceal uncertainty. This article proposes an Independent Human–AI Prescription Second-Reader Model for selected high-risk prescriptions. The model begins with a human first read, followed by a separately configured AI review activated through a locally validated risk-trigger gate. The AI may detect, prioritize, challenge, explain, or abstain, but it may not prescribe, authorize, independently release a prescription, or adjudicate unresolved conflict. Human and AI findings are reconciled through six proposed states: concordant clearance, concordant concern, AI-only concern, human-only concern, competing interpretations, and unresolved uncertainty or abstention. Disagreement initiates data verification, contextual recovery, independent professional reassessment, prescriber clarification, and proportionate escalation. The model also incorporates auditability, subgroup assessment, workload monitoring, drift surveillance, version control, and suspension or requalification after material change. Evaluation must address incremental interception of clinically important prescription problems together with false reassurance, misleading challenge, delay, alert burden, inequity, and responsibility diffusion. The contribution is conceptual rather than validated: it organizes independent review, authority boundaries, conflict resolution, and governance into a testable human–AI safety architecture. Its applicability remains conditional on prescription type, data quality, professional capacity, local workflow, external validation, and prospective evaluation of the combined work system. </p>
      </abstract>
      <kwd-group>
                <kwd>Digital pharmacy</kwd>
                <kwd>Artificial intelligence</kwd>
                <kwd>Pharmacy practice</kwd>
                <kwd>Medication safety</kwd>
                <kwd>Human–AI collaboration</kwd>
                <kwd>Clinical decision support</kwd>
              </kwd-group>
    </article-meta>
  </front>
</article>