{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:43:56Z","timestamp":1785800636005,"version":"3.56.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":64,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Pharm Health Care Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative nausea and vomiting (PONV) is a common surgical complication that delays recovery and increases healthcare costs. Although U.S. guidelines recommend multimodal, risk-stratified prophylaxis, Japan lacks unified national guidelines, resulting in practice variation. Despite expanded insurance coverage for 5-HT\u2083 receptor antagonists, sustained adherence to best practices requires a multidisciplinary framework. We implemented a pharmacist-led, multidisciplinary PONV prevention protocol and evaluated its impact on PONV incidence among adults undergoing elective surgery across multiple specialties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a pharmacist-led multidisciplinary PONV prevention protocol based on U.S. guideline algorithms, recommending\u2009\u2265\u20092 and \u22653 prophylactic agents for medium- and high-risk patients, respectively. Pharmacists in the admission support center collected preoperative risk factors, while operating room pharmacists relayed assessments to anesthesiologists and nurses. We conducted a retrospective observational study of patients aged\u2009\u2265\u200918\u2009years undergoing elective gastrointestinal or gynecological surgery under general anesthesia. We compared 110 and 255 patients in the pre- and post-intervention groups, respectively, focusing on patients at medium to high risk. For primary analysis, we performed 1:1 propensity score matching (PSM) using five covariates to control for confounding. Conditional logistic regression evaluated intervention effects while accounting for the matched design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final analysis included 106 controls and 243 intervention patients. PSM produced 103 well-balanced matched pairs (standardized differences\u2009&lt;\u20090.1). Conditional logistic regression showed that the pharmacist-led intervention significantly reduced PONV occurrence (odds ratio [OR] 0.308, 95% confidence interval [CI], 0.139\u20130.680). Prophylactic agent use increased significantly after the intervention (OR 3.95, 95% CI 2.43\u20136.54), with dexamethasone (OR 5.92, 95% CI 3.03\u201311.60) and 5-HT\u2083 receptor antagonists (OR 4.98, 95% CI 2.69\u20139.22) showing the largest increases. Dopamine antagonists and total intravenous anesthesia administration also showed upward trends, though without statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The implementation of a pharmacist-led multidisciplinary PONV prevention protocol was associated with a lower incidence of PONV in medium- to high-risk patients. Pharmacist-conducted preoperative risk assessment improved the implementation of risk-based prophylaxis within a multidisciplinary framework. These findings suggest that pharmacist-driven collaborative approaches may facilitate more consistent PONV prophylaxis in clinical settings lacking unified guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40780-026-00590-2","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T01:45:38Z","timestamp":1780278338000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contribution of pharmacist intervention to postoperative nausea and vomiting prophylaxis in routine multidisciplinary practice: a retrospective observational study"],"prefix":"10.1186","volume":"12","author":[{"given":"Kotaro","family":"Sato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuma","family":"Koinuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Omata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiko","family":"Iguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"issue":"3","key":"590_CR1","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1213\/00000539-199909000-00022","volume":"89","author":"A Macario","year":"1999","unstructured":"Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg. 1999;89(3):652\u201358. https:\/\/doi.org\/10.1213\/00000539-199909000-00022.","journal-title":"Anesth Analg"},{"issue":"4","key":"590_CR2","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1007\/s12630-011-9660-x","volume":"59","author":"I Parra-Sanchez","year":"2012","unstructured":"Parra-Sanchez I, Abdallah R, You J, Fu AZ, Grady M, Cummings K, et al. Une analyse \u00e9conomique des temps et mouvements pour les naus\u00e9es et vomissements postop\u00e9ratoires en chirurgie d\u2019un jour. Can J Anesth\/J Can Anesth. 2012;59(4):366\u201375. https:\/\/doi.org\/10.1007\/s12630-011-9660-x.","journal-title":"Can J Anesth\/J Can Anesth"},{"issue":"3","key":"590_CR3","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1097\/00000542-199909000-00022","volume":"91","author":"CC Apfel","year":"1999","unstructured":"Apfel CC, L\u00e4\u00e4r\u00e4 E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999;91(3):693\u2013693. https:\/\/doi.org\/10.1097\/00000542-199909000-00022.","journal-title":"Anesthesiology"},{"issue":"2","key":"590_CR4","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1213\/ANE.0000000000004833","volume":"131","author":"TJ Gan","year":"2020","unstructured":"Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, et al. Fourth Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2020;131(2):411\u201348. https:\/\/doi.org\/10.1213\/ANE.0000000000004833.","journal-title":"Anesth Analg"},{"key":"590_CR5","doi-asserted-by":"publisher","first-page":"179","DOI":"10.5649\/jjphcs.47.179","volume":"47","author":"I Kenzo","year":"2021","unstructured":"Kenzo I, Shinya S, Hiroyuki S, Kanako N, Yayoi S, Ranko Y, et al. The impact of pharmacist intervention on the incidence of postoperative nausea and vomiting and the anesthesiologist\u2019s decision on preventive measures. Iryo-Yakugaku. 2021;47(4):179\u201384. https:\/\/doi.org\/10.5649\/jjphcs.47.179","journal-title":"Iryo-Yakugaku"},{"issue":"1","key":"590_CR6","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s40780-022-00242-1","volume":"8","author":"S Nagase","year":"2022","unstructured":"Nagase S, Imaura M, Nishimura M, Takeda K, Takahashi M, Taniguchi H, et al. Usefulness of criteria for intraoperative management of postoperative nausea and vomiting. J Pharm Health Care Sci. 2022;8(1):11. https:\/\/doi.org\/10.1186\/s40780-022-00242-1.","journal-title":"J Pharm Health Care Sci"},{"issue":"5","key":"590_CR7","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1111\/jcpt.13110","volume":"45","author":"R Wang","year":"2020","unstructured":"Wang R, Dong X, Zhang X, Gan S, Kong L, Lu X, et al. Pharmacist-driven multidisciplinary initiative continuously improves postoperative nausea and vomiting in female patients undergoing abdominal surgery. J Clin Pharm Ther. 2020;45(5):959\u201367. https:\/\/doi.org\/10.1111\/jcpt.13110.","journal-title":"J Clin Pharm Ther"},{"key":"590_CR8","first-page":"65","volume":"56","author":"M Yusuke","year":"2021","unstructured":"Yusuke M, Masato N, Akiyoshi K, Shinnichi M, Koichi H. Effect of opioid use during epidural anesthesia on postoperative nausea and vomiting and postoperative pain in gynecological laparotomy. J Educ Chang Hiroshima Soc Hosp Pharmacists. 2021;56(2):65\u201370.","journal-title":"J Educ Chang Hiroshima Soc Hosp Pharmacists"},{"issue":"3","key":"590_CR9","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1213\/ane.0b013e31816194fb","volume":"106","author":"FO Kooij","year":"2008","unstructured":"Kooij FO, Klok T, Hollmann MW, Kal JE. Decision support increases guideline adherence for prescribing postoperative nausea and vomiting prophylaxis. Anesth Analg. 2008;106(3):893. https:\/\/doi.org\/10.1213\/ane.0b013e31816194fb.","journal-title":"Anesth Analg"},{"issue":"3","key":"590_CR10","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/00273171.2011.568786","volume":"46","author":"PC Austin","year":"2011","unstructured":"Austin PC. An introduction to propensity score Methods for reducing the effects of confounding in observational studies. Multivar Behav Res. 2011;46(3):399\u2013424. https:\/\/doi.org\/10.1080\/00273171.2011.568786.","journal-title":"Multivar Behav Res"},{"key":"590_CR11","unstructured":"Japanese Society of Hospital Pharmacists. Checklist for evidence-based pharmaceutical management of perioperative patients and pharmacist practices in operating rooms (2022 edition). Japanese. https:\/\/www.jshp.or.jp\/activity\/guideline\/20220901-1.html. 21 Dec 2025."}],"container-title":["Journal of Pharmaceutical Health Care and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40780-026-00590-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40780-026-00590-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40780-026-00590-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:44:12Z","timestamp":1785797052000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40780-026-00590-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["590"],"URL":"https:\/\/doi.org\/10.1186\/s40780-026-00590-2","relation":{},"ISSN":["2055-0294"],"issn-type":[{"value":"2055-0294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]},"assertion":[{"value":"22 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Medical Ethics Committee of the Yokohama Minato Red Cross Hospital (reference number: 2023\u201315). Although this study did not obtain direct consent from the patients, information about the study was disclosed to them, affording them an opportunity for refusal.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"68"}}