Introduction: Bio-psycho-social complexity is related to multi-morbidity, high utilization of healthcare services, and psychological, socioeconomic, and cultural barriers. Measuring biopsychosocial complexity among patients with diabetes is needed to improve health outcomes. This study was conducted to measure the burden of biopsychosocial complexity and its influence on the quality and clinical outcomes of care in patients with diabetes. Methods: A cross-sectional study was conducted among patients with diabetes attending family medicine centers in South India. A validated INTERMED questionnaire with four domains (biological, psychological, social, and healthcare utilization) was used. The sample size was 215, and data were collected using convenience sampling. Results: The burden of complexity among study participants with diabetes was 39.5%. Approximately 74.9% of the participants had a good quality of care with a score of >six and 52.1% of the participants were found to have good clinical outcomes with a score of >5. A significant association was found between complexity and male sex, lower socioeconomic status, the presence of more than three morbidities, more than six medications, <3 visits, complications, and hospitalizations over the previous year. Conclusion: Primary care for patients with diabetes requires comprehensive contextual and individual assessments, beyond clinical diagnoses, investigations, and prescriptions. Addressing bio-psycho-social factors is vital, and the care pathway should aim to tailor glycemic targets, medications, and follow-up plans in the context of patients.
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Harika et al. (2025) studied this question.
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