Background. Medication-related harm remains a major challenge in residential aged care, particularly in the context of polypharmacy and clinical complexity. Pharmacogenomic (PGx) testing determines how a person’s genetic makeup affects their body’s response to medications, supporting safer and more individualised prescribing. However, there is limited evidence on how PGx can be implemented within existing aged care service and workforce models. Methods. A PGx-guided medication management service was implemented across five NSW residential aged care homes. Residents were offered PGx testing via buccal swab, with results incorporated by pharmacists into routine Residential Medication Management Reviews. Service delivery outcomes were evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Results. Two hundred residents were recruited, representing approximately 30% of residents across participating homes. Clinical staff integrated consent and sample collection into routine care with minimal workflow impact (15–30 minutes per resident). Pharmacists reported incorporating PGx information without substantially extending review duration; interpretation time was typically around 5 minutes. Approximately one-third of the residents (32%) had a clinically significant prescribing consideration requiring dose adjustment, monitoring or alternative therapy, most commonly involving cardiovascular, psychotropic and pain management medications. Conclusion. This study demonstrates the feasibility of integrating PGx‑guided medication management into existing residential aged care workflows using current workforce roles. Findings highlight how pharmacist-enabled use of emerging technologies may complement established medication review processes and inform evolving models of service delivery, contributing to innovation-led discussions on workforce and medication management reform in aged care.