Application of Clinical Decision Support System to Assist Breast Cancer Patients with Lifestyle Modifications during the COVID-19 Pandemic: A Randomised Controlled Trial

Nutrients. 2021 Jun 20;13(6):2115. doi: 10.3390/nu13062115.

Abstract

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.

Keywords: Mediterranean diet; breast cancer; cardiovascular risk factors; clinical decision support systems; obesity; oxidative stress; quality of life.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adipose Tissue / metabolism
  • Adult
  • Behavior Therapy
  • Blood Glucose / metabolism
  • Body Mass Index
  • Body Weight
  • Breast Neoplasms*
  • COVID-19*
  • Cholesterol, LDL / blood
  • Decision Support Systems, Clinical*
  • Diet, Mediterranean*
  • Female
  • Health Status
  • Humans
  • Life Style*
  • Middle Aged
  • Obesity / etiology
  • Obesity / prevention & control*
  • Pandemics*
  • Patient Compliance
  • Quality of Life
  • SARS-CoV-2
  • Triglycerides / blood

Substances

  • Blood Glucose
  • Cholesterol, LDL
  • Triglycerides