The findings of an updated Cochrane review that are summarised in this paper highlight the lack of existing intervention studies of suitable quality aimed at improving the appropriate use of polypharmacy in older patients. Overall, the interventions included in this review demonstrated benefits in this respect based on observed reductions in inappropriate prescribing. However, it remains unclear if interventions resulted in clinically significant improvements in terms of hospital admissions, medication-related problems and patients’ overall quality of life. Future studies would benefit from guidance relating to intervention development, evaluation and reporting. In addition, more detailed and systematic reporting of interventions in published papers could facilitate replication of effective interventions and uptake into clinical practice.