Introducing a palliative care chapter in the New Zealand Formulary

The May release of the New Zealand Formulary (NZF) includes a new chapter on palliative care treatments for adults (Chapter 16). This chapter has been developed according to international best practice guidelines and New Zealand expert opinion.

The new chapter provides clinical guidance on alleviating distressing symptoms that are often encountered in patients receiving palliative care, such as pain, nausea, vomiting, restlessness, confusion and breathlessness. Each sub-section of the chapter contains notes discussing management options for a particular group of symptoms. Pharmacological treatment options are provided, alongside non-pharmacological management advice where appropriate.

For example:

Clicking on a pharmacological treatment option 1 (highlighted in blue) takes you to that drug monograph. Here you will find information about the dosing regimen for use in palliative care.

For example:

In some instances the dosing regimen will also contain a link (see notes) 2 back to further information in the palliative care chapter.

Many recommendations in palliative care involve using medicines with unapproved indications or routes of administration. There are also sometimes prescribing options described that may be outside of a practitioner’s usual scope of practice. Prescribers can contact their local palliative care service (e.g. a hospital, hospice or community palliative care team) for further advice if required.

For example:

The New Zealand Formulary explicitly mentions instances where discussion with a palliative care service is required before prescribing a medicine. 3

The New Zealand Formulary welcomes your feedback on the new palliative care chapter: www.nzf.org.nz/Feedback