Implementation of a Medication Reconciliation Televisit Model in Phase I Oncology Clinical Trials

PURPOSE Accurate medication reconciliation is critical in oncology trials to mitigate drug-drug interactions, address eligibility, and enhance patient safety, especially given that patients with cancer often experience polypharmacy (≥5 medications) and medication lists in electronic medical records (EMRs) are often incomplete or outdated. To streamline screening for phase I trials, a pharmacist-led medication reconciliation televisit (MRT) model was implemented to improve baseline medication list accuracy and reduce in-clinic time. METHODS From December 2022 to January 2025, one MRT occurred for each adult patient screening for phase I trials, after trial consent but before registration. Pharmacists reviewed EMRs and dispense histories and then conducted structured phone interviews to review prescription, over-the-counter (OTC), herbal, and cannabis usage, including name, strength, dose, frequency, start dates, indications, and ingredients. Inactive medications were discontinued, allergies were updated, and patient concerns and medication details were documented. RESULTS Five hundred twenty-five MRTs across 82 trials had a median turnaround of 2 days and median duration of 45 minutes including documentation. Patients (median age 61 years) reported a median of 12 medications; 5% required interpreter support. MRTs in April 2024 and later captured additional data: 64% required outside source reconciliation, 32% modified allergies, a median of three medications were added, two were changed, and three were discontinued (median call time 18 minutes). Cannabis use reporting increased 500% and herbal OTC use increased 77%. CONCLUSION Pharmacist-led MRTs with flexible remote scheduling supported the presence of caregivers and medications, reducing list omissions and hospital chair time for patients. Sponsors and study teams gained more accurate baseline records, lowering the risk of unknown prohibited medications. This scalable telemedicine model offers potential for broader use in oncology trials, improving efficiency and patient safety.