An editorial highlights that this study has once again presented the concern that the challenges of polypharmacy are not going away and patients are at risks of interactions now more than ever. It notes that these results are consistent with the large body of evidence which has documented a supposed unstoppable rise in medication use amongst older adults. The biggest increases documented include statins and vitamin D which calls into question the appropriateness of therapy. The commentator highlights the need to create systems that support an ongoing process of medicines monitoring which would enable period assessment of benefits, harms and ongoing need. Tools specifically addressing the issue of polypharmacy in older adults have been developed including the STOPP/START medication review tool and their use is being encouraged in the UK.