Effect of Pharmacist Intervention on the Incidence of Postoperative Nausea and Vomiting: A Retrospective Study

Postoperative nausea and vomiting (PONV) is a frequent perioperative complication that leads to decreased patient satisfaction, delayed recovery, and hospital readmission. The updated 2020 PONV prevention guidelines recommend multimodal prophylaxis for patients with one or more risk factors, however, the effectiveness of pharmacist intervention in this context has not been fully evaluated. This retrospective study assessed the effectiveness of pharmacist-led PONV risk assessment and prophylaxis recommendations. Patients aged ≥15 years who underwent general anesthesia at the Kobe University Hospital International Clinical Cancer Research Center were included. The non-intervention group consisted of 524 patients treated between July and September 2022, and the intervention group consisted of 474 patients treated between January and March 2023. The primary endpoint was the incidence of PONV within 24 hours postoperatively; the secondary endpoints were the use of rescue antiemetics and the number of prophylactic measures implemented. The incidence of PONV decreased significantly from 16.4％ in the non-intervention group to 10.1％ in the intervention group (P < 0.01). The use of rescue antiemetic also significantly declined from 14.1％ to 9.1％ (P = 0.014). The number of prophylactic measures significantly increased in the intervention group, with particularly marked benefits in high-risk patients, where combinations including total intravenous anesthesia might be most effective in preventing PONV. These findings suggest that pharmacist intervention based on PONV risk assessment may help reduce the incidence of PONV.