BackgroundThe impact of Home Medicines Reviews (HMRs) on long-term health outcomes among individuals receiving long-term in-home aged care services is unknown. ObjectivesTo examine associations between HMR provision and hospitalization, long-term care facility (LTCF) entry and mortality among older people receiving long-term in-home aged care services. MethodsThis retrospective cohort study included individuals aged 65–105 years from three Australian states who accessed in-home aged care services between 2013 and 2017. Using propensity score matching, HMR recipients (n = 1530) were matched to individuals who did not receive an HMR (n = 1530). Associations between HMR provision and outcomes were estimated using multivariable regression models. ResultsOver a median of 414 days (interquartile range 217–650) of follow-up, HMR provision was not associated with hospitalizations for unplanned events (subdistribution hazard ratio (sHR) 1.04, 95%CI 0.96–1.14), falls-related hospitalizations (sHR 0.97, 95%CI 0.83–1.13), LTCF entry (sHR 0.97, 95%CI 0.83–1.13), or all-cause mortality (adjusted HR 0.86, 95%CI 0.72–1.01). ConclusionsIn a cohort of older people receiving long-term in-home aged care services, no differences in unplanned hospitalizations, falls, LTCF entry or mortality were observed those with HMRs compared to those that did not receive an HMR.