What steps are involved in medication reconciliation during end-of-life transitions to ensure safety?

• A. Review all medications, discontinue non-beneficial drugs, adjust dosing, and treat symptoms effectively with appropriate agents.
• B. Focus only on reducing total number of medications, stopping all chronic therapies, maintaining current doses, and adding more analgesics.
• C. Increase all doses to maximize symptom relief without review.
• D. Delegate medication decisions to family members.

Answer: (A)

Medication reconciliation in end-of-life transitions centers on safety by ensuring every medication still serves the patient’s comfort-focused goals, is appropriate for current physiology, and contributes to symptom relief rather than harm. The best choice walks through reviewing all medications, stopping those that are no longer beneficial or aligned with care goals, adjusting dosing to account for changes in organ function and overall prognosis, and ensuring effective symptom control with suitable agents (for pain, nausea, dyspnea, agitation, etc.). This approach reduces polypharmacy risks, avoids unnecessary side effects, and keeps treatment aligned with comfort. Choices that focus only on reducing meds without ensuring symptom relief, or that push doses up without proper review, or that place decisions in the hands of family without professional guidance, do not support safe or goal-aligned end-of-life care.