Abstract
Precision medicine has emerged as a transformative approach to healthcare by integrating pharmacogenomics and artificial intelligence (AI) to deliver personalized therapeutic interventions and improve clinical outcomes. This study examined the role of pharmacogenomics and AI in enhancing precision drug therapy and optimizing surgical outcomes in Pakistan. Specifically, the study investigated the direct effects of pharmacogenomics and AI on precision drug therapy and surgical outcome optimization, as well as the mediating role of precision drug therapy. A quantitative, cross-sectional research design was employed, and primary data were collected from physicians, surgeons, clinical pharmacists, anesthesiologists, geneticists, and other healthcare professionals working in public and private tertiary healthcare institutions across Pakistan. Data were analyzed using Structural Equation Modeling (SEM) to evaluate the proposed relationships among the study constructs. The findings indicated that pharmacogenomics and AI significantly improved precision drug therapy by facilitating personalized medication selection, dosage optimization, and the reduction of adverse drug reactions. Precision drug therapy was also found to have a significant positive effect on surgical outcome optimization by improving perioperative management, patient safety, and postoperative recovery. Furthermore, precision drug therapy partially mediated the relationships between pharmacogenomics, AI, and surgical outcome optimization. The study concludes that integrating pharmacogenomics with AI-based clinical decision-support systems can substantially strengthen precision medicine practices in Pakistan by enhancing therapeutic effectiveness, reducing medication-related complications, improving surgical outcomes, and increasing healthcare efficiency. The findings provide important theoretical, clinical, and policy implications for the implementation of personalized medicine and digital health technologies in developing healthcare systems.