# A standard handoff with medication reconciliation at every cancer care transition

Source: https://onco.cc/ideas/idea-acc-transition-handoff-medication-reconciliation/  
OnCo record `idea-acc-transition-handoff-medication-reconciliation` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Cancer care has more handoffs than most conditions, hospital to home, surgery to chemotherapy, oncology back to the family doctor, and information and medications are lost at each. A standard handoff checklist plus pharmacist medication reconciliation covering oral anticancer drugs, steroids, anticoagulants and opioids at every transition would prevent avoidable adverse drug events cheaply.

## Summary

Cancer care involves more transitions than most conditions, and each is a point where information and medications are lost or duplicated. Standardised handoff tools and pharmacist-led medication reconciliation reduce adverse drug events in general medicine; oncology-specific versions covering oral anticancer agents, steroids, anticoagulants, and opioids are rare. Implementing them as a required step at defined transitions is inexpensive.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Standard transition handoffs with reconciliation will reduce medication discrepancies at transitions by at least 50% and reduce 30-day readmissions after discharge by 10%.
- Rationale: Transition interventions have consistent evidence in heart failure and surgery; oncology patients have higher medication complexity and more transitions.
- Proposed test: Run a stepped implementation across a cancer network with discrepancy audits, adverse drug events, and readmissions as endpoints.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Bottleneck evidence (Fragmented care and guideline gaps): Hanna et al., Mortality due to cancer treatment delay: systematic review and meta-analysis (BMJ 2020): https://doi.org/10.1136/bmj.m4087

## Connected records

- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Older and multimorbid patients are excluded and undertreated](https://onco.cc/bottlenecks/b-aging-comorbidity/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- key papers: [Mortality due to cancer treatment delay: systematic review and meta-analysis](https://onco.cc/key-papers/paper-hanna-bmj/)

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