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The general practice pharmacist (GPP) role in Australia is evolving. A pilot GPP model of care developed to optimize medicines for patients at risk of medicine-related harm was evaluated. The aims of this study were 2-fold: to evaluate the GPP model of care on medicines optimization, with a focus on deprescribing, in a population at risk of harm due to their medicines, or clinical condition, and to explore the perspectives of study participants. This single practice study involved two phases. Phase 1 (September 2019–May 2020): at risk patients were referred to the GPP for medication reconciliation, recommendations for optimization, and when appropriate, deprescribing support, especially for opioids. Medication plans were developed with patients, GPs, and the GPP. Quantitative data collected from patient records included demographics, discrepancies, medicines reviewed, GPP recommendations and uptake …