Clinical decision support systems (CDSS) are data aggregation tools based on computer technology that assist clinicians to promote healthy weight management and prevention of cardiovascular diseases. We carried out a randomised controlled 3-month trial to implement lifestyle modifications in breast cancer (BC) patients by means of CDSS during the COVID-19 pandemic. In total, 55 BC women at stages I-IIIA were enrolled. They were randomly assigned either to Control group, receiving general lifestyle advice (n = 28) or the CDSS group (n = 27), to whom the CDSS provided personalised dietary plans based on the Mediterranean diet (MD) together with physical activity guidelines. Food data, anthropometry, blood markers and quality of life were evaluated. At 3 months, higher adherence to MD was recorded in the CDSS group, accompanied by lower body weight (kg) and body fat mass percentage compared to control (p < 0.001). In the CDSS arm, global health/quality of life was significantly improved at the trial endpoint (p < 0.05). Fasting blood glucose and lipid levels (i.e., cholesterol, LDL, triacylglycerols) of the CDSS arm remained unchanged (p > 0.05) but were elevated in the control arm at 3 months (p < 0.05). In conclusion, CDSS could be a promising tool to assist BC patients with lifestyle modifications during the COVID-19 pandemic.
Community pharmacies are an under-utilized setting for the provision of primary and preventative care measures, especially the provision of clinical dietary care. The SARS-CoV-2 pandemic presented a unique opportunity to study pharmacist-based nutritional counseling in the absence of ready access to primary nutritional care. In the present interventional pilot study, we analyzed the efficacy of a Clinical Decision Support System (CDSS) for community pharmacy integration on patient weight management, monitoring, and goal setting over a 4-week period. 57 Greek adult patients (16 males and 41 females) of a community pharmacy in the greater Athens area were enrolled in the intervention and subsequently assigned a hypo- or iso-caloric diet according to baseline anthropometric measurements, total daily energy expenditure, medical history, and drug treatment status as assessed by the CDSS. At the end of the intervention period participant weight (kg) and corresponding Body Mass Index (BMI) (kg/ m2) calculations were recorded to gauge sample diet and CDSS recommendation efficacy. Among patients who remained diet compliant to study completion, body weight and BMI were significantly decreased in the hypo-caloric diet group compared to baseline (n=13) (mean difference = -2.685 kg, p = 0.004; mean difference = -1.112 kg/m2, p = 0.004, respectively). No significant change in body weight nor BMI from baseline of isocaloric diet compliant patients was registered (n=9) (p=0.273; p=0.320, respectively), succeeding in the purported goal of weight maintenance. This study provides preliminary evidence for the efficacy of a CDSS in assisting pharmacists with nutritional assessment, screening, and sample diet counselling concordant with patient dietary and weight-loss requirements. This trial also builds on emerging research into the broadening purview of traditional pharmacy services in primary care settings.
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