Faculty Bibliography

BACKGROUND:The American Society of Addiction Medicine Patient Placement Criteria (ASAM PPC) are guidelines for matching addiction patients to an optimal level of care (LOC). South Korea lacked a systematic approach to assigning alcohol use disorder patients to suitable treatment. To address this, Park et al. translated the ASAM PPC into Korean, creating the Korean Patient Placement Criteria (KPPC). We aim to assess the efficacy of the KPPC by evaluating whether receiving KPPC-matched treatment would result in longer periods of alcohol abstinence and higher number of treatment program completion. METHODS:This is an observational, multi-site study of 225 individuals with hazardous alcohol use or alcohol dependence, defined by Alcohol Use Disorder Identification Test score of 10 or more for men, and 6 or more for women. We evaluated patients using KPPC at baseline and one-month follow-up visits and recommended a LOC at every visit. Patients freely chose to receive KPPC-matched treatment or not. We examined the duration of alcohol abstinence and number of one-month treatment program completion within a three-month period. RESULTS:Of the 225 participants, 47 never pursued their matched level of care treatment, 54 pursued it once, and 124 pursued it twice. Individuals who received KPPC-matched treatment once had significantly higher odds of achieving alcohol abstinence (OR = 2.23), with greater odds when they received KPPC-matched treatments twice (OR = 2.88). The association was also significant for treatment completion, with greater odds of completing treatment program for one KPPC-matched treatment (OR = 3.28) and two KPPC-matched treatments (OR = 3.19). CONCLUSIONS:Individuals who followed the KPPC matched level of care had longer periods of alcohol abstinence and better treatment completion. Our results should encourage community addiction management centers and hospitals to adopt KPPC for classifying treatment settings for alcohol use disorder patients. Further research is warranted to maximize the potential benefits of KPPC.

OBJECTIVES/OBJECTIVE:Studies evaluating weight changes during the coronavirus disease 2019 (COVID-19) pandemic have yielded inconsistent results, and most of those studies were based on self-reported anthropometric measures. We investigated changes in body mass index (BMI), professionally measured waist circumference (WC), and metabolic syndrome components from before to during the pandemic in a sample of the adult population in Korea. METHODS:This retrospective study included 1,118 male and female (age≥18 years) who underwent health checkups at a university medical center between January 1, 2016 and March 31, 2022. Changes in BMI, lifestyles, and metabolic syndrome components during the pandemic were analyzed using the paired t-test, McNemar test, generalized estimating equations, and repeated-measures analysis of variance. RESULTS:Changes in body weight, BMI, and body fat percentage during the pandemic were not clinically significant. However, statistically significant results were found for decreased physical activity (p<0.001) and WC (p<0.001), and exacerbation of all metabolic syndrome components (except serum triglyceride levels). Moreover, the metabolic syndrome prevalence increased significantly from 20.2% to 31.2% during the pandemic (p<0.001). The prevalence of abdominal obesity and high fasting blood glucose levels also significantly increased from 2019 to 2021. CONCLUSIONS:Metabolic syndrome, its components, and fat distribution worsened significantly after the implementation of social distancing and lockdowns, despite no clinically significant changes in body weight and BMI. Further studies on the post- pandemic period should investigate the long-term impact of social lockdowns on BMI and the prevalence of metabolic syndrome.