Medication review in cancer pain management: A patient safety framework for optimizing pain control and reducing medication-related harm/adverse drug events

ObjectiveThis article proposes a structured, practice-oriented medication review framework designed to optimize pain control and reduce medication-related harm in patients with cancer. By repositioning medication review as the central, decision-guiding process in cancer pain management, this article addresses a persistent implementation gap and presents an actionable pathway applicable across diverse oncology settings.Data SourcesA narrative review of published literature was conducted using PubMed, MEDLINE, and relevant clinical guideline databases. Search terms included cancer pain management, medication review, adverse drug events, polypharmacy, opioid safety, pharmaceutical care, patient safety, and transitions of care. International guidelines from the WHO, EAPC, and ESMO were also consulted.Data SummaryCancer pain remains undertreated in up to 40% of patients, with polypharmacy affecting 57-84% of older adults with cancer and significantly increasing the risk of adverse drug events (ADEs). Evidence supports structured medication review as an effective strategy to identify drug-related problems, optimize analgesic regimens, prevent medication errors, and improve continuity of care. Key components of an effective medication review framework include evaluation of regimen appropriateness, opioid safety monitoring, interdisciplinary collaboration, patient and caregiver education, and structured medication reconciliation at care transitions.ConclusionsStructured medication review, repositioned as a proactive patient safety intervention rather than a routine pharmacy task, offers a coherent and scalable framework for improving cancer pain management. Integration of this approach into oncology practice has the potential to reduce preventable medication-related harm, enhance interdisciplinary collaboration, and improve patient-centered outcomes across the cancer care continuum.