Although considerable research and development work has been undertaken on the role of General Practitioners (GPs) and pharmacists in medication management, monitoring and referral, there is limited research into a role in medication management for community nurses. One hundred and thirteen older people living at home and receiving community nursing care were assessed for their knowledge of, and ability to manage their medication regimen. From these data, a nurse-initiated intervention was developed that included nursing interventions and referral pathways to GPs for people who might benefit from a GP and/or pharmacist medication review. A subgroup of 24 participants with diminished knowledge of medications or ability to manage their regime (considered to be at risk of drug-related problems) who were followed up, demonstrated an increase in knowledge, some alteration in compliance aids and with no statistically significant change in medication regime complexity. This paper details an approach to medication review and intervention suitable for community nurses that includes referral pathways within the medication team.