The SIMPATHY (Stimulating Innovation Management of Polypharmacy and Adherence in The Elderly) consortium have explored how healthcare management programmes can be implemented to improve medication safety and prevent patient harm by addressing the appropriate use of multiple medications (polypharmacy). Fundamental to these programmes is the principle that providers work in partnership with patients to enable shared decision making regarding medication, which improves patient adherence and medicines related outcomes. This report sets out the case for prioritising working together now to address inappropriate medication use over the next decade, to ensure the quality, economic and political systems are put in place to improve medication safety for patients. There are encouraging signs of the increasing recognition of these challenges, and the timeliness of this report. In March 2017, the World Health Organisation (WHO) launched a global challenge to address medication safety, with polypharmacy as a flagship element. A special interest group will be launched by the International Foundation on Integrated Care in May 2017