<p>Polypharmacy is very common among older adults and is associated with poor health outcomes. This scoping review aimed to understand the underlying factors for poor medication taking by older patients and potential solutions to mitigate these risks. The ability to take medications and adherence are affected by various factors related to patients, treatments, health conditions and socio-demographics, healthcare providers and the healthcare systems. Educational and behavioural interventions are used alone or in combination for the optimisation medication use. Medication review and deprescribing, including regimen simplification, by trained practitioners has the potential to enhance patient safety and reduce healthcare costs. Engaging the patient and family may bring about additional benefits. Various technology-based interventions to promote self-efficacy are evolving and are used to support consumer self-management.</p>