With accelerating population aging, the safety of oral medication among older patients with chronic diseases after hospital discharge has become a major public health challenge. Age-related physiological decline, polypharmacy, and limited health literacy—coupled with inadequate professional guidance and insufficient social support—collectively expose this population to a heightened risk of medication errors, drug-drug interactions, and poor adherence. This review synthesizes recent evidence on risk factors and emerging management strategies. At the patient level, standardized nursing protocols and stratified management models (e.g., red-yellow-green risk classification) have been introduced to improve adherence. At the institutional level, multidisci plinary collaboration has been leveraged to optimize prescribing and medication counseling. At the societal level, community-based and family-supported care models are being promoted to strengthen continuity of medication management. However, heterogeneous effects of standardized interventions, gaps in primary-care services, and limited technological capacity continue to constrain real-world implementation. Strengthening pharmacist-led services at the primary-care level, establishing an integrated “home-community-hospital” coordination network, and enhancing policy support may help bridge current practice gaps and provide an evidence-based foundation for longitudinal management of older adults with chronic diseases.
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