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2 "Chul-Woung Kim"
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Original Articles
Associations between usual source of care characteristics and health outcomes in diabetes mellitus: a focus on medication adherence and healthy behaviors in Korea
Seung Eun Lee, Chul-Woung Kim, Ji Eun Bae, Jee Hyun Choi
Epidemiol Health. 2025;47:e2025063.   Published online December 2, 2025
DOI: https://doi.org/10.4178/epih.e2025063
  • 3,932 View
  • 86 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study investigated the associations between usual source of care (USC) characteristics, which incorporate primary care functions, and medication adherence and healthy behaviors in Korean adults with diabetes.
METHODS
We used data from 1,543 adults with diabetes in the 2020 Korea Health Panel Survey. USC was categorized into 5 types based on whether a regular doctor was identified and whether that provider fulfilled comprehensiveness and coordination functions. Multivariable logistic regression was used to assess associations with medication adherence and healthy behaviors.
RESULTS
A significant difference in medication adherence was observed by USC type, although no significant associations emerged for healthy behaviors (smoking, drinking, exercise). Compared to the group without a USC, patients whose regular doctor fulfilled either function were 2.38 times more likely to adhere (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.70 to 3.32), and those whose doctor fulfilled both functions were 1.84 times more likely to adhere (OR, 1.84; 95% CI, 1.31 to 2.59). This association was particularly strong for adherence to medication dosage, frequency, and timing.
CONCLUSIONS
The findings underscore that the functional quality of the USC, particularly the fulfillment of comprehensiveness and coordination, is crucial in improving medication adherence. Simply having a USC is insufficient. The lack of association with healthy behaviors suggests that physicians may focus more on pharmacological control, highlighting the need for multifaceted interventions.
Summary
Korean summary
본 연구는 단순히 주치의가 있는 것만으로는 당뇨병 환자의 복약 순응에 불충분하며, 일차 의료 기능을 충실히 수행하는 상용치료원만이 복약 순응과 유의한 관련이 있음을 입증했습니다. 하지만 상용치료원이 건강 행동 개선과는 관련이 없음을 확인하여, 의료진이 생활 습관 개선에는 영향을 주지 못하고 있음을 시사했습니다. 이러한 결과는 만성질환 관리를 개선하기 위해 상용치료원의 일차 의료 기능을 강화해야 한다는 정책적 근거를 제공합니다.
Key Message
This study shows that simply having a usual source of care (USC) is insufficient; only USCs that fully perform primary care functions are significantly associated with better medication adherence in diabetic patients. However, USC was not linked to improved health behaviors, suggesting providers fail to influence lifestyle changes. The findings provide policy evidence to reinforce the primary care functions of USCs to enhance chronic disease management.

Citations

Citations to this article as recorded by  
  • Association Between Usual Source of Care Types and Health Behaviors: Smoking Cessation, Alcohol Abstinence, and Physical Activity
    Jeong-Hee Kang, Chul-Woung Kim
    Research in Community and Public Health Nursing.2026; 37: 101.     CrossRef
  • Income level and the risk of incident dementia among adults aged ≥50 with newly diagnosed type 2 diabetes: a population-based cohort study using the NHIS-Senior database in South Korea
    Su-Min Park, Ah Jung Ko, Jae Hyeok Lim, Eun-Cheol Park
    BMJ Open.2026; 16(7): e112641.     CrossRef
Patterns and predictors of smoking relapse among inpatient smoking intervention participants: a 1-year follow-up study in Korea
Seung Eun Lee, Chul-Woung Kim, Hyo-Bin Im, Myungwha Jang
Epidemiol Health. 2021;43:e2021043.   Published online June 9, 2021
DOI: https://doi.org/10.4178/epih.e2021043
  • 27,692 View
  • 476 Download
  • 25 Web of Science
  • 28 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to identify relapse patterns in smokers who participated in an inpatient treatment program and to investigate factors related to relapse.
METHODS
The participants comprised 463 smokers who participated in an inpatient treatment operated by the Daejeon Tobacco Control Center from 2015 to 2018. Participants received high-intensity smoking cessation intervention for 5 consecutive days, including pharmacotherapy and behavioral support, and continued with follow-up for 1 year to determine whether they maintained smoking cessation after discharge from inpatient treatment. Kaplan-Meier and Cox proportional hazard models were used in the analysis.
RESULTS
Participants’ relapse rate within 1 year was 72.8%, and 59.8% of participants smoked again within 6 months after participation. A higher number of counseling sessions was significantly associated with a lower risk of relapse (hazard ratio [HR], 0.23; 95% confidence interval [CI], 0.17 to 0.32 for ≥9 vs. ≤5 counseling sessions). Conversely, higher relapse rates were significantly associated with the use of nicotine replacement therapy (NRT) (HR, 1.91; 95% CI, 1.43 to 2.55 for use vs. no use), and higher levels of baseline expired carbon monoxide (CO) (HR, 1.58; 95% CI, 1.21 to 2.06 for expired CO concentrations of 10-19 ppm vs. expired CO concentrations <10 ppm).
CONCLUSIONS
High-intensity smoking cessation interventions in hospital settings can be effective for smoking cessation in smokers with high nicotine dependence. In addition, the results suggest that for quitters to maintain long-term abstinence, they should receive regular follow-up counseling for 1 year after completing a high-intensity smoking cessation intervention.
Summary
Korean summary
• 한국은 국가금연정책의 일환으로 중증고도흡연자를 위해 고강도의 입원형 금연 중재 프로그램을 운영하고 있다. • 고강도 금연 중재를 받은 후 첫 6개월은 재흡연이 가장 빈번히 일어나는 시기였다. • 장기 금연을 유지하기 위해서는 고강도 금연 중재 후에도 1년간 지속적인 추후 상담이 이루어져야 한다.
Key Message
• South Korea operates a high-intensity inpatient treatment program for heavy smokers. • Relapse typically occurred in the first 6 months after completing the intervention. • Continuous 1 year follow-up counseling is important for long-term abstinence.

Citations

Citations to this article as recorded by  
  • Evaluation of a Community-based Quality Improvement Smoking Cessation Program Using the Ottawa Model During COVID-19
    Salma Mahmoodianfard, Ayah Rashwan, Javad Heshmati, Terefe Gelibo, Mustafa Coja, David Sabapathy, Shamara Baidoobonso, Karen Phillips, Laura MacDonald, Laura Lee Noonan, Kerri-Anne Mullen, Hassan Mir
    CJC Open.2026; 8(5): 607.     CrossRef
  • GLP-1 receptor agonists and smoking cessation: therapeutic promise beyond glycemia
    Gaurab Bhaduri, Shatavisa Mukherjee, Rakesh Parikh, Sriparna Karak, Jyotirmoy Pal
    Endocrine.2026;[Epub]     CrossRef
  • Smoking cessation and weight loss before ventral hernia repair – can we really justify this? A single center cohort study
    Line Marker, Anna Fisker, Frederik Helgstrand
    Hernia.2026;[Epub]     CrossRef
  • A systematic review and meta-analysis of randomized controlled trials evaluating the effectiveness of smoke cessation intervention in adults (aged 55–64 years) with cardiovascular diseases
    Mohammad Asif, Kaneez Fatima, Sadaf Jamal Gilani, Mohamad Taleuzzaman, Mohammad Umar, Syed Salman Ali
    Aging Medicine and Healthcare.2026;[Epub]     CrossRef
  • Convergence of TMS Sites and Lesion Locations Associated With Nicotine Addiction Improvement on a Common Brain Circuit
    Sanaz Khosravani, William Drew, Michael R. Apostol, Timothy Jordan, Thuc Doan P. Ngo, Nicholas Kearley, Edythe D. London, Andrew Leuchter, Michael D. Fox, Nicole Petersen
    American Journal of Psychiatry.2026;[Epub]     CrossRef
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    Eunsil Cheon, Sung-il Cho
    Nicotine & Tobacco Research.2026;[Epub]     CrossRef
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    Ashley M. White, Daryl L. Richie, Percell T. Kendrick, Kathleen R. McNealy, Robert M. Flight, Hunter N.B. Moseley, Christa L. Corley, Cassandra D. Gipson
    Addiction Neuroscience.2026; 20: 100263.     CrossRef
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    Sultan Abdullah Albqami, Ali Hassan Almaqsudi, Hajar Saeed Alqahtani, Nawaf Ahmed Alqahtani Alsaqer, Afnan Mohammad Aseeri, Abdullah Mohammed Abdullah Al-Qahtani, Abdulmohsen Mohammed Abdullah Al-Qahtani
    Healthcare.2026; 14(14): 2030.     CrossRef
  • Prognosis after switching to electronic cigarettes following percutaneous coronary intervention: a Korean nationwide study
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    Research in Community and Public Health Nursing.2025; 36: 210.     CrossRef
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