How a Residential Medication Management Review works
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Referral. A GP, or certain specialists, refers the resident in writing. A nurse, pharmacist or family member can recommend a review, but a recommendation is not a referral. Only a GP can claim the Medicare item for referring 42.
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Eligibility. Permanent residents of a funded aged care home who are at risk of, or experiencing, problems with their medicines, where the referrer confirms a clinical need 42.
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Consent and interview. Consent is obtained, and the credentialed pharmacist interviews the resident face to face and assesses their medicines 42.
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The report. The pharmacist writes a report with findings and recommendations, gives it to the referrer and discusses it with them 42.
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The plan. A medication management plan is agreed between the resident, or staff if the resident is cognitively impaired, and the referrer, and shared with consent with the resident’s healthcare team, including their community pharmacy 42.
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Follow-up. Up to two follow-up services within nine months of the first interview, where clinically needed 42.
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How often. A new review can be done when more than 24 months have passed or when the referrer considers it clinically necessary. The rules state that a review must not be triggered solely by an anniversary date 42.
On-site pharmacists
Since 1 July 2024, the Australian Government has funded aged care homes to engage pharmacists to work on site. Taking part is voluntary. Funding covers one on-site pharmacist per 250 beds, in 50-bed steps of roughly one day a week. A home with an on-site pharmacist cannot also receive Residential Medication Management Reviews and Quality Use of Medicines services from visiting pharmacists 43.
On-site pharmacists review medicines regularly, follow up problems as they arise, and work with GPs, nurses and the community pharmacy 43.
The evidence
An on-site pharmacist in the care team
Promising, not yet provenOne Australian trial found fewer potentially inappropriate medicines with an on-site pharmacist. The main results report prescribing measures, not health outcomes.
The evidence
The PiRACF cluster randomised trial placed an on-site pharmacist in seven Australian homes (560 residents) for 12 months and compared them with eight homes (737 residents) receiving usual care. The proportion of residents taking at least one potentially inappropriate medicine fell (odds ratio 0.50, 95% CI 0.34 to 0.75), as did anticholinergic burden and antipsychotic dose 44. Over the year the pharmacists completed 1,022 clinical medication reviews. Prescribers accepted 51.5% of their recommendations, and deprescribing was the most commonly accepted outcome 45.
In practice
The trial involved 15 homes and was not blinded 44. Whether the change in prescribing improves residents’ health needs further study.
What residents and families can expect
A medication review is a chance to raise concerns. The resident and family can tell the pharmacist and GP what matters to them, what side effects they have noticed, and whether swallowing tablets is a problem. The review produces recommendations. Decisions are made by the prescriber with the resident or their decision-maker.
Why the response to a review matters
A review changes care only if its recommendations are considered and acted on. In the on-site pharmacist trial, about half of recommendations were accepted 45. An analysis of falls trials suggested that involving a prescriber from the resident’s usual team is one of the features of reviews that work 14.
Related pages on this site
Sources cited on this page
- 14 Suen J, Narayan S, Seppala LJ, et al. Features of successful medication review and deprescribing interventions for fall prevention in residential aged care facilities: an intervention component analysis of an updated systematic review. Age Ageing. 2025;54(8):afaf230. (13 trials; hypothesis-generating.) View source
- 42 Pharmacy Programs Administrator. Residential Medication Management Review (RMMR) Program Rules. August 2026. View source
- 43 Australian Government Department of Health, Disability and Ageing. About aged care on-site pharmacists (Aged Care On-site Pharmacist measure). Accessed October 2026. View source
- 44 Haider I, Kosari S, Naunton M, et al. Impact of on-site pharmacists in residential aged care facilities on the quality of medicines use: a cluster randomised controlled trial (PiRACF study). Sci Rep. 2023;13:15962. (15 Australian homes; not blinded.) View source
- 45 Haider I, Kosari S, Naunton M, et al. The role of on-site pharmacist in residential aged care facilities: findings from the PiRACF study. J Pharm Policy Pract. 2023;16:82. (Descriptive study within the trial.) View source
See every source cited across the medicines and deprescribing section →
Written by Dr Josh Hatch, FRACGP. General information only, reflecting his reading of the published evidence as at October 2026. It is not individual medical advice, does not create a doctor–patient relationship, and must not be used to start, stop or change any treatment. Evidence and Australian regulatory, PBS and program arrangements change — always confirm current advice with the treating GP, pharmacist or specialist.
This is general education, not a clinical protocol. The doctors who practise with Umbrella Aged Care are independent general practitioners, and each makes their own clinical decisions with the resident and family. Your GP’s advice for an individual may differ from what is written here. If it does, please ask them to talk it through with you.