Anticholinergic side effects of medications often misdiagnosed as cognitive function decline in the elderly. The study aims to explore the effectiveness of home medication reviews on reducing anticholinergic burden caused by medications with anticholinergic properties in elderly patients in Australia. The study was a qualitative, prospective, observational case-control study. Interviews at baseline and six-month were performed. Medications changes were theoretically possible to reduce the Anticholinergic Cognitive Burden score, but occasionally are impractical to implement. When it was safe to implement, recommendations were in most cases dismissed by doctors. The study could not draw a clear conclusion on pharmacist ability to improve older patients’ cognitive functions as the recommendations were not tested. The home medication review process is lacking the step that obligate the referring doctor to communicate the reason for not implementing the recommendations made by the pharmacist who needs to be addressed by Medicare. This will ensure that medication use is optimised.