Bridging the Gap: Community Pharmacists’ Burgeoning Role as Point-Of-Care Providers During the COVID-19 Pandemic Through the Integration of Emerging Technologies

Abstract

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.

Improving Adherence to the Mediterranean Diet in Early Pregnancy Using a Clinical Decision Support System; A Randomised Controlled Clinical Trial

“…The present CDSS was developed by our research team in 2016, and ever since, it has been applied in clinical practice to assist dieticians in the nutritional care process, such as nutritional screening and monitoring. The CDSS allows patients to visit their personal dietary regimen at any time and to record and monitor their own progress, e.g., goals of body weight, physical activity, and consumption of fruits, vegetables, and legumes, via a login password [ 25 , 26 , 27 , 28 ]. Records can automatically be made available to the attending health care professional (e.g., physician, dietician), who will in turn assess patient progress and nutritional status.…”

Implementation of a Nutrition-Oriented Clinical Decision Support System (CDSS) for Weight Loss during the COVID-19 Epidemic in a Hospital Outpatient Clinic: A 3-Month Controlled Intervention Study

“…Then, patient-specific evaluations are provided to the clinician, who makes the final decision [1]. Similarly, a nutritionoriented CDSS helps dietitians to calculate patients' nutritional needs more quickly and easily compared to paper or simply computerized methods [3]. Such a system reduces the time required for data calculation and analysis during nutritional assessment [3].…”

“…Similarly, a nutritionoriented CDSS helps dietitians to calculate patients' nutritional needs more quickly and easily compared to paper or simply computerized methods [3]. Such a system reduces the time required for data calculation and analysis during nutritional assessment [3]. Moreover, it ensures the implementation of a step-by-step nutrition care process (NCP) including nutritional assessment, diagnosis, intervention, monitoring and evaluation [4,5].…”

“…During this difficult time, the use of electronic medical records [11] and tele-health were recommended to provide and monitor nutritional care [7]. Within this scope, the CDSS developed by our group, named Nutrinet ® , aimed to provide distance lifestyle advice while avoiding visits to healthcare providers and minimizing the risk of COVID-19 infection [3]. The clinical efficacy of the CDSS used in the present study was recently demonstrated in patients with breast cancer [4], multiple sclerosis [12] and rheumatoid arthritis [13], as well as pregnant women [14].…”