# Medicines reconciliation at the start of anticancer treatment and at each move between care settings

Source: https://onco.cc/protocols/medicines-reconciliation-in-cancer-care/  
OnCo record `medicines-reconciliation-in-cancer-care` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Medicines reconciliation means making one accurate list of every medicine you take, including ones you buy and herbal remedies, and checking it against what the hospital thinks you take. It should happen before cancer treatment starts, when you go into hospital, when you move wards and when you go home.

## Summary

NICE NG5 (2015) uses the Institute for Healthcare Improvement's definition: identify an accurate list of a person's current medicines, compare it with the list in use, recognise and document discrepancies, and communicate the result; 'medicines' includes over-the-counter and complementary products. In an acute setting reconciliation should be done within 24 hours of a move between settings, or sooner if clinically necessary, may need repeating on admission, transfer and discharge, and should be done in primary care within a week of the practice receiving discharge information. It should be done by a trained, competent professional, ideally a pharmacist, pharmacy technician, nurse or doctor, and involve the patient and family.

Cancer-specific standards add the anticancer start point. ASCO-ONS (2024) requires the medication list, with over-the-counter medicines, herbal products and supplements, to be updated at every encounter and reviewed when it changes; BOPA (2025) puts the drug history and interaction check into the pharmacist's verification of the first cycle. Practice lags: across 21 Canadian cancer centres most collected a best possible medication history but full reconciliation was uncommon, and one centre's improvement project reached a documented history in 26.6% of patients starting systemic therapy and full reconciliation in 4.7%. Where it is done, it finds things: before early-phase trials, pharmacist reconciliation in 501 patients uncovered 35% of the medicines patients were taking and 51% of prohibited or monitored drugs that oncologists had missed.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: medication reconciliation; med rec; MedRec; best possible medication history; BPMH; drug history before chemotherapy; medicines reconciliation on admission

## Connected records

- protocols: [Anticancer treatment prescribing and pharmacy verification before each cycle](https://onco.cc/protocols/sact-prescribing-and-pharmacy-verification/), [Drug, herbal and food interaction review for anticancer treatment](https://onco.cc/protocols/anticancer-drug-interaction-review/), [Oral anticancer medicines at home: prescribing, teaching, adherence, storage, handling and disposal](https://onco.cc/protocols/oral-anticancer-medicines-at-home/)

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