Use of a clinical decision support system to support pharmacy students’ management of minor illnesses: A single-arm quasi-experimental pre–post study
DOI:
https://doi.org/10.46542/pe.2026.261.306317Keywords:
Clinical decision support system, Minor illness, Pharmaceutical prescription, Pharmacy education, Pharmacy student, Novel Teaching MethodsAbstract
Background: Pharmacists are expected to manage minor illnesses using clinical judgment and evidence-based practices. Clinical decision support systems may assist pharmacy students in developing pharmaceutical prescribing skills. The objective is to assess changes in pharmacy students’ prescribing competence before and after using SEMIOPHARM/1, an educational clinical decision support system for minor illnesses.
Methods: This single-arm quasi-experimental pre–post study was conducted between August and September 2021 with undergraduate pharmacy students at the Federal University of Sergipe, Brazil. Students completed simulated upper respiratory tract cases before and after software-supported training. Prescriptions were evaluated using a six-item competence rubric. As outcomes were ordinal, paired comparisons used the Wilcoxon signed-rank test with Bonferroni adjustment.
Results: Of 36 students completing baseline assessment, 18 completed both phases and were included in paired analyses. Post-intervention improvements were observed in identifying therapeutic needs, selecting treatment, reporting presentation route, dose, route, and frequency, and recommending non-pharmacological measures. “Duration of treatment” showed no significant improvement after adjustment for multiple comparisons.
Conclusion: Use of SEMIOPHARM/1 was associated with improved prescribing competence in selected domains; however, findings should be interpreted as preliminary due to the single-arm design, small paired sample, and absence of a control group.
References
Agência Nacional de Vigilância Sanitária. (2021). Instrução Normativa IN nº 86, de 12 de março de 2021: Define a Lista de Medicamentos Isentos de Prescrição [Normative Instruction IN No. 86 of March 12, 2021: Defines the list of non-prescription medicines]. https://anvisalegis.datalegis.net/action/ActionDatalegis.php?acao=detalharAto&cod_menu=1696&cod_modulo=134&desItem=&desItemFim=&nomeTitulo=codigos&numeroAto=00000086&orgao=DC%2FANVISA%2FMS&seqAto=000&tipo=INM&valorAno=2021
Albarrak, A. I., Al Rashidi, E. A., Fatani, R. K., Al Ageel, S. I., & Mohammed, R. (2014). Assessment of legibility and completeness of handwritten and electronic prescriptions. Saudi Pharmaceutical Journal, 22(6), 522–527. https://doi.org/10.1016/j.jsps.2014.02.013
Al-Diery, T., Hejazi, T., Al-Qahtani, N., ElHajj, M., Rachid, O., & Jaam, M. (2024). Evaluating the use of virtual simulation training to support pharmacy students’ competency development in conducting dispensing tasks. Currents in Pharmacy Teaching and Learning, 16(12), 102199. https://doi.org/10.1016/j.cptl.2024.102199
Beshir, S. A., Mohamed, A. P., Soorya, A., Sir Loon Goh, S., Moussa El-Labadd, E., Hussain, N., & Said, A. S. A. (2022). Virtual patient simulation in pharmacy education: A systematic review. Pharmacy Education, 22(1), 954–970. https://doi.org/10.46542/pe.2022.221.954970
Briz-Ponce, L., Juanes-Méndez, J. A., García-Peñalvo, F. J., & Pereira, A. (2016). Effects of mobile learning in medical education: A counterfactual evaluation. Journal of Medical Systems, 40(6), Article 136. https://doi.org/10.1007/s10916-016-0487-4
Conselho Federal de Farmácia. (2013). Resolução nº 586, de 29 de agosto de 2013: Regula a prescrição farmacêutica e dá outras providências [Resolution No. 586 of August 29, 2013: Regulates pharmaceutical prescription and provides other provisions]. https://www.cff.org.br/userfiles/file/noticias/Resolução586_13.pdf
Conselho Federal de Farmácia. (2016). Serviços farmacêuticos diretamente destinados ao paciente, à família e à comunidade: Contextualização e arcabouço conceitual [Pharmaceutical services directly aimed at the patient, the family, and the community: Contextualization and conceptual framework]. Conselho Federal de Farmácia. https://www.cff.org.br/userfiles/Profar_Arcabouco_TELA_FINAL.pdf
Da Rocha, C. E., Lessa, F. A. S., Venceslau, D. O., Sakuraba, C. S., Barros, I. M. C., & de Lyra, D. P., Jr. (2016). Development of a decision support system for the practice of responsible self-medication. International Journal of Clinical Pharmacy, 38(1), 152–161. https://doi.org/10.1007/s11096-015-0223-z
Dabidian, A., Kinny, F., Steichert, M., Schlottau, S., Bartel, A., Schwender, H., & Laeer, S. (2024). Impact of a clinical decision support system on the efficiency and effectiveness of performing medication reviews in community pharmacies: A randomised controlled trial. Healthcare, 12(23), Article 2491. https://doi.org/10.3390/healthcare12232491
DiVall, M. V., Hayney, M. S., Marsh, W., Neville, M. W., O’Barr, S. A., Sheets, E. D., & Calhoun, L. D. (2013). Perceptions of pharmacy students, faculty members, and administrators on the use of technology in the classroom. American Journal of Pharmaceutical Education, 77(4), Article 75. https://doi.org/10.5688/ajpe77475
Hussein, G., & Kawahara, N. (2006). Adaptive and longitudinal pharmaceutical care instruction using an interactive voice response/text-to-speech system. American Journal of Pharmaceutical Education, 70(2), Article 37. https://doi.org/10.5688/aj700237
Johnson, A. E., Barrack, J., Fitzgerald, J. M., Sobieraj, D. M., & Holle, L. M. (2021). Integration of a virtual dispensing simulator “MyDispense” in an experiential education program. Pharmacy, 9(1), Article 48. https://doi.org/10.3390/pharmacy9010048
Kaur, T. (2017). Impact of technology on student’s way of perceiving information. Educational Quest: An International Journal of Education and Applied Social Sciences, 8(Special), 263–268. https://doi.org/10.5958/2230-7311.2017.00062.9
Makhlouf, A. M., Ibrahim, M. I. M., Awaisu, A., Vyas, S. K., & Yusuff, K. B. (2021). Management of common minor ailments in Qatar: Community pharmacists’ self-perceived competency and its predictors. PLOS ONE, 16(8), Article e0256156. https://doi.org/10.1371/journal.pone.0256156
Mazan, J., Komperda, K., & D’Souza, J. (2022). Effects of virtual simulation on student pharmacists’ ability to assess self-care patient cases. Currents in Pharmacy Teaching and Learning, 14(7), 863–869. https://doi.org/10.1016/j.cptl.2022.07.001
Menendez, E., Balisa-Rocha, B., Jabbur-Lopes, M., Costa, W., Nascimento, J. R., Dósea, M., Silva, L., & Lyra Junior, D. (2015). Using a virtual patient system for the teaching of pharmaceutical care. International Journal of Medical Informatics, 84(9), 640–646. https://doi.org/10.1016/j.ijmedinf.2015.05.015
Mertens, J. F., Kempen, T. G. H., Koster, E. S., Deneer, V. H. M., Bouvy, M. L., & van Gelder, T. (2024). Pharmacists and pharmacy students’ perceptions on how a new teaching model supports their clinical decision-making. Currents in Pharmacy Teaching and Learning, 16(10), Article 102136. https://doi.org/10.1016/j.cptl.2024.102136
Mesquita, A. R., Souza, W. M., Boaventura, T. C., Barros, I. M. C., Antoniolli, A. R., Silva, W. B., & Lyra, D. P., Jr. (2015). The effect of active learning methodologies on the teaching of pharmaceutical care in a Brazilian pharmacy faculty. PLOS ONE, 10(5), Article e0123141. https://doi.org/10.1371/journal.pone.0123141
Mikhael, E. M., Al-Hamadani, F. Y., & Hadi, A. M. (2022). Design and evaluation of a new mobile application to improve the management of minor ailments: A pilot study. BMC Health Services Research, 22, Article 446. https://doi.org/10.1186/s12913-022-08292-9
Nakhla, N., & Shiamptanis, A. (2021). Pharmacist prescribing for minor ailments service development: The experience in Ontario. Pharmacy, 9(2), Article 96. https://doi.org/10.3390/pharmacy9020096
Phanudulkitti, C., Puengrung, S., Meepong, R., Vanderboll, K., Farris, K. B., & Vordenberg, S. E. (2023). A systematic review on the use of virtual patient and computer-based simulation for experiential pharmacy education. Exploratory Research in Clinical and Social Pharmacy, 11, Article 100316. https://doi.org/10.1016/j.rcsop.2023.100316
Ramos, D. C., Ferreira, L., dos Santos Júnior, G. A., Ayres, L. R., & Esposti, C. D. D. (2022). Pharmacist prescribing: A review of perceptions and attitudes of patients, pharmacists and other interested professionals. Ciência & Saúde Coletiva, 27(9), 3531–3546. https://doi.org/10.1590/1413-81232022279.19972021EN
Richardson, M., Khouja, C., Sutcliffe, K., Hinds, K., Brunton, G., Stansfield, C., & Thomas, J. (2018). Self-care for minor ailments: Systematic reviews of qualitative and quantitative research. EPPI-Centre, Social Science Research Unit, UCL Institute of Education, University College London. https://discovery.ucl.ac.uk/id/eprint/10055525/
Rude, T. A., Eukel, H. N., Ahmed-Sarwar, N., Sutton Burke, E., Anderson, A. N., Riskin, J., & Caldas, L. M. (2023). An introductory over-the-counter simulation for first-year pharmacy students using a virtual pharmacy. American Journal of Pharmaceutical Education, 87(2), Article ajpe8940. https://doi.org/10.5688/ajpe8940
Saab, A., Fawaz, S., White, K., & Bach, A. (2018). Exploring U.S. consumers’ knowledge of, attitudes toward, and practices with OTC medications. Journal of the American Pharmacists Association, 58(3), Article e26. https://doi.org/10.1016/j.japh.2018.04.004
Shahmoradi, L., Safdari, R., Ahmadi, H., & Zahmatkeshan, M. (2021). Clinical decision support systems-based interventions to improve medication outcomes: A systematic literature review on features and effects. Medical Journal of the Islamic Republic of Iran, 35, Article 27. https://doi.org/10.47176/mjiri.35.27
Sousa, A. da S., Veloso, W. F., & Marquez, C. O. (2023). Clinical management from an innovative perspective: Exploring new approaches in pharmaceutical prescription. Research, Society and Development, 12(14), Article e14121444463. https://doi.org/10.33448/rsd-v12i14.44463
Turney, C. S. M., Robinson, D., Lee, M., & Soutar, A. (2009). Using technology to direct learning in higher education. Active Learning in Higher Education, 10(1), 71–83. https://doi.org/10.1177/1469787408100196
Vale, B. N. do. (2018). The responsibilities of the pharmacist in pharmaceutical prescription. Revista Cereus, 10(3), 179–201. https://doi.org/10.18605/2175-7275/cereus.v10n3p179-201
White, K., Fawaz, S., Saab, A., & Bach, A. (2018). Exploring how knowledge, attitudes, and recommendation sources affect OTC medication use in U.S. adults. Journal of the American Pharmacists Association, 58(3), Article e194. https://doi.org/10.1016/j.japh.2018.04.004
You, J. H., Wong, F. Y., Chan, F. W., Wong, E. L., & Yeoh, E. K. (2011). Public perception on the role of community pharmacists in self-medication and self-care in Hong Kong. BMC Clinical Pharmacology, 11, Article 19. https://doi.org/10.1186/1472-6904-11-19
Yusuff, K. B., Makhlouf, A. M., & Ibrahim, M. I. (2021). Community pharmacists’ management of minor ailments in developing countries: A systematic review. International Journal of Clinical Practice, 75(10), Article e14424. https://doi.org/10.1111/ijcp.14424
Zary, N., Johnson, G., Boberg, J., & Fors, U. G. (2006). Development, implementation and pilot evaluation of a web-based virtual patient case simulation environment—Web-SP. BMC Medical Education, 6, Article 10. https://doi.org/10.1186/1472-6920-6-10
