Residential Medication Management Reviews (RMMR)

14 Jan

Medications are meant to help — but over time, they can quietly become part of the problem.

In residential aged care, it’s common for people to be taking multiple medicines, often prescribed by different doctors over many years. When health changes, routines shift, or new symptoms appear, medications that were once appropriate can start to cause harm — through falls, confusion, poor appetite, fatigue, or loss of independence. A Residential Medication Management Review is one of the most practical ways to pause, step back, and check whether a medication plan still makes sense for the person today.

What this is in practice

A Residential Medication Management Review (RMMR) is a structured review of a resident’s medicines, carried out by a credentialled pharmacist at the request of the person’s GP. It is designed to make sure medications remain necessary, safe, and appropriate as a person’s health, mobility, cognition, and daily needs change.

In practice, an RMMR is not just a compliance requirement. It is one of the key safety checks in residential aged care — particularly for people who are older, frailer, living with dementia, or taking multiple medications.

How an RMMR happens

An RMMR begins when the resident’s GP initiates a referral. This often occurs:

when someone enters residential care,
after a fall or hospital admission,
when new medications are started,
if there are changes in alertness, behaviour, appetite, mobility, or pain, or when medicines have not been reviewed for some time.)

The credentialled pharmacist reviews:

all prescribed medications,
over-the-counter medicines and supplements,
how and when medicines are administered,
recent health events and incident reports,
known side effects, interactions, and duplication risks.

The pharmacist then provides a written report with recommendations to the GP. The GP considers those recommendations and decides whether any medication changes are needed.

What it looks like on the ground

A well-done RMMR connects medication use to everyday life in the home. It should consider questions such as:

Are all of these medicines still needed?
Could medications be contributing to falls, dizziness, confusion, or reduced mobility?
Are multiple medicines doing similar jobs?
Is pain being adequately assessed — including pain on movement?
Are medicines affecting appetite, sleep, continence, or engagement?
Is the timing, dose, or form of medication still appropriate?

Importantly, an RMMR looks beyond diagnoses and considers how the person is actually functioning day to day.

Why RMMRs matter

Older people are more vulnerable to medication-related harm. Changes in metabolism, kidney function, balance, and muscle strength mean that medication effects can shift over time.

RMMRs help to:

reduce unnecessary or duplicate medications,
lower the risk of falls and hospital transfers,
identify side effects early,
support clearer care planning for staff,
align medications with the person’s current goals and quality of life.

In a system under pressure, RMMRs are one of the few structured opportunities to slow things down and reassess safely.

How often should they occur

An RMMR is not a one-off event. It can be requested:

on entry to residential care,
after a significant change in health or function,
when behaviour or cognition changes,
when medications are added or adjusted,
or periodically as part of good ongoing care.

Families and residents can ask the GP whether an RMMR has been done recently, and whether a review would be timely.

Why it’s ok to ask

Asking about an RMMR isn’t questioning staff or medical judgment. It’s about making sure medications still support the person’s health, comfort, and independence — now, not just when they were first prescribed.

Often, medication reviews lead to clearer plans, fewer complications, and better day-to-day wellbeing. That helps residents, families, staff, and clinicians alike.