AimsPolypharmacy is increasingly common in older adults, placing them at risk of medication‐related harm (MRH). Patients are particularly vulnerable to problems with their medications in the period following hospital discharge due to medication changes and poor information transfer between hospital and primary care. The aim of the present study was to investigate the incidence, severity, preventability and cost of MRH in older adults in England postdischarge.MethodsAn observational, multicentre, prospective cohort study recruited 1280 older adults (median age 82 years) from five teaching hospitals in Southern England, UK. Participants were followed up for 8 weeks by senior pharmacists, using three data sources (hospital readmission review, participant telephone interview and primary care records), to identify MRH and associated health service utilization.ResultsOverall, 413 participants (37%) experienced MRH (556 MRH events per 1000 discharges), of which 336 (81%) cases were serious and 214 (52%) potentially preventable. Four participants experienced fatal MRH. The most common MRH events were gastrointestinal (n = 158, 25%) or neurological (n = 111, 18%). The medicine classes associated with the highest risk of MRH were opiates, antibiotics and benzodiazepines. A total of 328 (79%) participants with MRH sought healthcare over the 8‐week follow‐up. The incidence of MRH‐associated hospital readmission was 78 per 1000 discharges. Postdischarge MRH in older adults is estimated to cost the National Health Service £396 million annually, of which £243 million is potentially preventable.ConclusionsMRH is common in older adults following hospital discharge, and results in substantial use of healthcare resources.

The Roma are the most populous marginalised community in Europe and have some of the greatest health needs. There is a higher prevalence of communicable and non-communicable diseases within the community and significantly shorter life expectancies than national averages. Efforts by governments across Europe to address these health inequalities have been relatively weak and the Roma suffer poorer access to health care, education and employment in every country that they inhabit in comparison to the majority population. As the socioeconomic determinants of health become better understood over the past decade, it is becoming clear that societies with greater inequalities are less healthy overall. It is important for public health across Central and Eastern Europe that the health needs of the Roma are prioritised by governments concerned. We provide a review of the literature on the health inequalities of the Roma community in Europe.

MRH is common after hospital discharge in older adults, but methodological inconsistencies between studies and a paucity of data on risk factors limits clear understanding of the epidemiology. There is a need for international consensus on conducting and reporting MRH studies. Data from large, multicenter studies examining a range of biopsychosocial risk factors could provide insight into this important area of safety.