Management of Depression and Obesity in Primary Care
Korean Journal of Family Practice.2024;14(4):149-149. doi:10.21215/kjfp.2024.14.4.149
Korean Journal of Family Practice
2011 (1, 1) to Present ISSN: 2233-9019
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Endoscope Cleaning and Disinfection Guidelines for Primary Care Physicians
Korean Journal of Family Practice.2024;14(4):165-171. doi:10.21215/kjfp.2024.14.4.165
The reprocessing of gastrointestinal endoscopes and accessories, including pre-cleaning, cleaning, high-level disinfection, rinsing, drying, and storage, is essential for preventing infections during endoscopic procedures. The risk of infection is significantly minimized when these processes are performed properly. However, the reprocessing environment in primary care settings differs from that in endoscopy centers, and ongoing advancements in medical practices and reprocessing technologies highlight the need for updated, context-specific guidelines. The Korean Academy of Family Medicine has developed these guidelines, tailored to the unique conditions of primary care settings, through a comprehensive review of both international and local standards, as well as systematic reviews of relevant literature. This guideline presents step-by-step procedures and key principles for effective endoscope reprocessing, with a focus on the needs of primary care institutions. By adhering to these guidelines, primary care physicians can maintain the highest standards of safety and effectiveness, minimize infection risks, and promote optimal clinical outcomes.
Smoking Cessation Treatment in Primary Care
Korean Journal of Family Practice.2024;14(4):184-192. doi:10.21215/kjfp.2024.14.4.184
Smoking is a major health risk factor contributing to substantial morbidity and mortality worldwide. Although most smokers express a desire to quit— or they attempt to do so—, achieving smoking cessation solely through individual willpower is often challenging. Primary care plays a pivotal role in supporting smoking cessation efforts by increasing the likelihood of success. Even brief advice from a physician significantly increases the chance of quitting, and combining counseling with pharmacotherapy further improves cessation rates. Particular attention is required for smokers in special populations, such as those with cardiovascular diseases or mental health conditions, wherein tailored and proactive smoking cessation interventions are crucial. Digital health tools, including smartphone applications and text messaging interventions, have recently emerged as effective strategies to support personalized smoking cessation behaviors. Furthermore, institutional support, such as national programs, quitlines, and post-screening counseling for lung cancer, are critical resources that promote successful cessation. Primary care physicians are uniquely positioned to foster longterm smoking cessation success through sustained relationships with patients by leveraging these tools and resources to provide comprehensive and continuous care.
Comprehensive Geriatric Assessment for Evaluating the Health Status of Older Adults
Korean Journal of Family Practice.2024;14(4):156-164. doi:10.21215/kjfp.2024.14.4.156
In older patients with chronic and degenerative diseases (multiple morbidities), geriatric syndromes, chronic and complex problems should be comprehensively evaluated. Comprehensive geriatric assessment (CGA) includes simultaneous clinical, medical, and functional evaluation of older patients. The components of CGA include physical, psychological, and socio-environmental content. Exhibiting multiple morbidities, disease severity, multidrug intake (polypharmacy), and vaccinations were evaluated from a physical perspective. Geriatric syndromes should also be evaluated. Functional evaluations included visual acuity, hearing, upper and lower extremity function, gait ability, balance, falls, urinary incontinence, weight change, oral health, nutritional status, and pain. Psychological aspects, such as depression and cognitive function status, were evaluated. The residential environment, degree of family and social support, economic status, and advanced medical directives were evaluated from a socio-environmental perspective. Older patients with functional disabilities should be screened through CGA for various problems and geriatric syndromes. However, these issues require further evaluation, treatment, and management. Thus, the health and quality of life of older adults can be maintained and improved.
Geriatric Syndrome and Frailty in Older Individuals
Korean Journal of Family Practice.2024;14(4):172-176. doi:10.21215/kjfp.2024.14.4.172
Rapid aging has become a global issue, resulting in a significant increase in geriatric syndrome, a multifactorial clinical condition in older individuals characterized as a unified manifestation of accumulated multiple system impairments. Frailty, a clinical state of reduced physiological reserves, is an increasingly significant public health burden. Frailty can also be considered a syndrome as it involves a decline in physiological responses to stimuli, commonly referred to as stress, resulting in reduced homeostatic maintenance. Furthermore, sarcopenia, an age-related syndrome characterized by progressive loss of skeletal muscle mass and strength, is a major component of frailty. Consequently, understanding geriatric syndrome, frailty, and sarcopenia is important in older adult healthcare. Geriatric syndrome, including frailty, extends beyond the confines of traditional medicine. Geriatric syndrome is not an inevitable consequence of aging; rather, it is a condition that can be effectively mitigated through integrated care within medical and social welfare systems. Therefore, this study aimed to review geriatric syndrome and frailty, which are key factors in determining the health status of older individuals. In addition, effective methods for the prevention and management of geriatric syndrome are suggested.
The Importance of Dietary Intervention in Obesity Management
Korean Journal of Family Practice.2024;14(4):193-202. doi:10.21215/kjfp.2024.14.4.193
Obesity is a critical global health issue, with escalating prevalence over the past few decades. This review discusses the importance of dietary approaches in managing obesity, focusing on evidence-based strategies for weight loss and long-term health outcomes. Key interventions include low-calorie diets, very-low-calorie diets, and meal replacement programs, which have demonstrated varying efficacies in achieving weight reduction and improving metabolic health. Macronutrient-focused approaches such as low-carbohydrate, high-protein, and low-fat diets offer flexibility, and long-term results often depend on individual adherence. The quality and source of macronutrients are emphasized for achieving long-term health outcomes. To improve adherence to dietary therapy, time-restricted eating can be considered based on an individual’s lifestyle and health conditions. Emerging evidence supports dietary patterns such as the Mediterranean, Dietary Approaches to Stop Hypertension, vegetarian, and Nordic diets to improve cardiometabolic profiles. Personalized dietary interventions are crucial for sustainable lifestyle changes and the optimization of weight management.
Necessity and Components of Essential Health Screening for the Older Adult Population in Korea
Korean Journal of Family Practice.2024;14(4):177-183. doi:10.21215/kjfp.2024.14.4.177
With the aging population rapidly increasing, the prevalence of chronic diseases such as diabetes, hypertension, dyslipidemia, osteoporosis, and dementia, along with cancers and cardiovascular diseases, poses critical challenges to older adult health management. Early detection and prevention through comprehensive health screening are crucial for improving the quality of life and promoting healthy aging among older adults.This review highlights the necessity of older adult health screening in Korea and discusses its core components. Key elements include targeted history taking to assess medical and social factors, early diagnosis of chronic conditions through physical examinations, cancer screening (e.g., stomach, colorectal, and lung cancers), vaccination assessments, and functional evaluations to support independent living. Additionally, psychological health evaluations such as cognitive function and depression screening play a pivotal role in providing comprehensive care for older adults. By identifying and addressing health risks early, health screening enables tailored medical interventions, facilitates preventive care, and promotes independent and healthy living. Establishing a systematic and preventive screening system is essential to reduce the disease burden and ensure quality of life among Korea’s aging population.
Pharmacotherapy for Depression in Primary Care
Korean Journal of Family Practice.2024;14(4):150-155. doi:10.21215/kjfp.2024.14.4.150
The treatment for depression in primary care begins with detecting patients with depression among patients who complain physical symptoms. It is recommended to use screening tests in high-risk groups in order to increase efficiency. Measurement-based care is useful because it systematically uses verified assessment tools to assess severity and monitor treatment progress. Selective serotonine reuptake inhibitors (SSRIs), serotoninenorepinephrine reuptake inhibitors (SNRIs), mirtazapine, and vortioxetine are recommended as first-line drugs for treating major depressive disorder. Drug treatment consists of antidepressant monotherapy or combination therapy. The goal of acute phase pharmacotherapy is symptomatic remission in 6–12 weeks. The continuation phase corresponds to 4–9 months after acute phase, and the goal is to maintain the state of remission and prevent relapse. If symptoms do not improve within 2–4 weeks after starting antidepressants, the dose is optimized or increased. If there is no response after 4 weeks at the appropriate dose or tolerance is an issue, a different antidepressant should be prescribed. If antidepressant monotherapy is ineffective or anxiety, insomnia, pain, etc. are present, benzodiazepines, buspirone, nonsteroidal anti-inflammatory drugs (NSAIDs), estrogen, testosterone, etc. are added as augmentation, or a different class of antidepressants are combined. When remission continues for more than 6 months after antidepressant treatment and drug treatment is to be discontinued, antidepressants with a short half-life should not be discontinued abruptly.
Relationship between Vitamin D Levels and Sarcopenia: Insights from a Korean Population Study
Korean Journal of Family Practice.2024;14(4):203-210. doi:10.21215/kjfp.2024.14.4.203
Background:
Recent studies have shown that cells in various tissues express vitamin D receptors, indicating that vitamin D deficiency could increase the prevalence of several diseases, including sarcopenia, cardiovascular disease, obesity, and cancer. However, these studies were conducted in the West, and research on the correlation between vitamin D levels and sarcopenia is lacking in the East. This study aimed to examine the correlation between vitamin D levels and sarcopenia in older adults aged ≥65 years and contribute to the health of this population, which is prone to gradual decline due to falls or fractures.
Methods:
This cross-sectional investigation analyzed the data of 3,174 Korean adults aged ≥65 years, who participated in the Korea National Health and Nutrition Examination Survey. A diagnosis of sarcopenia was made in cases where the skeletal muscle mass was two standard deviations lower than the mean skeletal muscle mass of healthy adults aged 20–39 years; other cases were considered normal. A logistic regression analysis was performed to determine the effects of blood vitamin D levels on sarcopenia.
Results:
Vitamin D deficiency was associated with a significantly increased probability of sarcopenia in both males (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.29–2.68) and females (OR, 1.79; 95% CI, 1.30–2.47).
Conclusion
This finding suggests that maintaining adequate vitamin D levels could reduce the risk of sarcopenia in older individuals. The reduced risk of sarcopenia would subsequently decrease falls, fractures, and mortality rates, thereby enhancing the health of older adults.
Korean Journal of Family Practice.2024;14(4):211-219. doi:10.21215/kjfp.2024.14.4.211
Background:
The prevalence of obesity has been rapidly increasing among young adults. However, studies analyzing the comorbidities associated with obesity and related factors in Korean adults in their 20s and 30s are lacking. In this study, we aimed to analyze the prevalence of obesity, its comorbidities, and risk factors among young Korean adults.
Methods:
Data from the 2019–2021 Korea National Health and Nutrition Examination Survey were used to analyze the prevalence of obesity and its related comorbidities in 3,609 adults aged 19–39 years (Group 1). After excluding individuals with chronic diseases and a low body mass index, 2,582 adults (1,257 male and 1,325 female, Group 2) were included. Multivariate logistic regression analysis was conducted to calculate the odds ratios and 95% confidence intervals for obesity-related factors.
Results:
Among Korean adults aged 19–39 years, the prevalence of obesity, prediabetes, and prehypertension was 45.4%, 29.2%, and 31.1% in male and 20.5%, 17.7%, and 12.5% in female, respectively. Obesity was associated with lower education and higher stress levels in both sexes. In male, additional factors included marital status, lower income, alcohol use, and a history of smoking, whereas in female, obesity was linked to labor job or unemployment.
Conclusion
The prevalence of obesity, prediabetes, and prehypertension was high in young Korean adults, with obesity being associated with socioeconomic status, stress, and lifestyle factors. To prevent the development of cardiometabolic disease, tailored obesity prevention and management strategies that consider the risk factors for obesity in young adults are needed.
Country
Republic of Korea
Publisher
The Korean Academy of Family Medicine
ElectronicLinks
http://www.kjfp.or.krEditor-in-chief
Song, Sang Wook
kjfp@kafm.or.kr
Abbreviation
Korean J Fam Pract
Vernacular Journal Title
ISSN
2233-9019
EISSN
2233-9116
Year Approved
2019
Current Indexing Status
Currently Indexed
Start Year
2011
Description
Korean Journal of Family Practice (KJFP) is an open access, peer-reviewed, online-only general medical journal published bimonthly on the 20th of even months (February, April, June, August, October, and December).The official journal of the Korean Academy of Family Medicine, KJFP's main aim is to provide up-to-date evidence-based medical knowledge and high-quality continuing medical education for family physicians and other primary care clinicians
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