Norwegian College of General Practice/Norwegian Association of Old Age and Nursing Home Medicine

Consider the individual's life expectancy, condition and preferences to avoid extensive and unnecessary treatments or hospital admissions. Always assess the benefits of interventions and treatments. 

Avoid changing regular medications without assessing the overall medication regimen. Evaluate any changes after a certain period. 

Avoid initiating opioids for chronic non-malignant pain without a clinical assessment and pain evaluation. After initiation, effectiveness and side effects such as drowsiness and reduced activity should be assessed. 

Avoid renewing long-term proton pump inhibitors for gastrointestinal symptoms without a discontinuation trial every six months for most patients. When discontinuing, use gradual tapering to prevent rebound effects. 

Avoid initiating antihypertensive treatment in frail adults over 70 years with systolic blood pressure <160 mmHg or diastolic blood pressure <90 mmHg without assessing benefit versus risk 

Avoid prescribing lipid-lowering medications to patients over 85 years or those with limited life expectancy 

Avoid using medications that may cause low blood sugar to achieve HbA1c below 53 mmol/mol in frail older adults, as moderate control is usually preferable 