Introduction: Many older people take multiple medications to manage their co-morbid conditions. Managing these multiple medications is a complex task and often requires input from multiple stakeholders, including the older people themselves, their informal carers/family members and their health care practitioners (e.g. doctors, pharmacists and nurses). The aim of the MEMORABLE project, funded by the UK NIHR, was to better understand how medication management works in a community setting and how it may be effectively implemented. Method: A realist approach was used as part of the MEMORABLE project to synthesise primary data (interviews with relevant stakeholders) and secondary data (the literature). This approach was used to gain insight into how, why, for whom and in what circumstances medicine management works.Results: This project, which ended in December 2018, identified that medication management is a five stage process. Three of the stages involve older people and sometimes their informal carers/family members making decisions and following medication management routines that fit with their day-to-day lives, thereby creating a sense of control. The other two stages, involve older people making shared medication management decisions with their health care practitioners. This project also found that sense making, relationships, action and reflection/monitoring are key elements of each stage of the medication management process and that reviewing/reconciling medications contribute to burden mitigation across the entire process. Conclusion: MEMORABLE is the first study to use a realist approach to understand the complex task of medication management and how it works. The outcome-focused, evidence and experience based framework, established as part of this project, will be used to develop and trial future proposedinterventions to clarify the outcomes that older people, informal carers/family members and health care providers want from the medication management process.