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January 23, 2026Healthcare0 citationsOpen Access

Facilitators and Barriers of Using an Artificial Intelligence Agent in Chronic Disease Management: A Normalization Process Theory-Guided Qualitative Study of Older Patients with COPD

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SCShiya CuiSWShilei WangJDJingyi Deng

Key Points

  • This study aims to identify the facilitators and barriers to using AI agents in managing chronic obstructive pulmonary disease (COPD) among older patients.
  • Conducted semi-structured interviews with 28 older COPD patients
  • Utilized normalization process theory to guide the study
  • Analyzed themes related to facilitators and barriers in AI usage
  • Identified four main themes for facilitators: coherence, cognitive participation, collective action, and reflexive monitoring
  • Nine barriers were recognized including privacy conflicts, trust deficit, and technical anxiety
  • The findings suggest key factors that affect the implementation of AI in chronic disease management

Abstract

Objectives: This study aims to explore the facilitators and barriers in the process of using AI agents for disease management in older COPD patients. Methods: Based on the normalization process theory, a descriptive qualitative study was used to conduct semi-structured interviews with 28 older patients with COPD recruited from June to August 2025 in a Class A tertiary hospital in Wuxi, Jiangsu Province. Results: A total of 28 interviews were conducted. Four themes (Coherence, Cognitive Participation, Collective Action, Reflexive Monitoring), nine subthemes (recognition of intelligent technology;supported by policy discourse and the background of national-level projects; the creation of a family atmosphere; recommendations from HCPs; relief and social connection; new “doctor”–patient relationship and communication; eliminate the burden and return to life; benefit and value perception; right self-decision by AI) in facilitators and nine subthemes (privacy conflicts and trust deficiency; blurred boundaries of human–machine responsibility and authority; non-high-quality services are chosen reluctantly; technical anxiety; lack of motivation for continued engagement; extra burden; limitations of the physical environment; human–machine dialogue frustration; a sense of uncertainty about the future of AI) in barriers were extracted. Conclusions: This study identified key factors influencing the use of AI agents in chronic disease management in older patients with COPD. The results provide directions for improving the implementation and sustainable use of AI health technologies.

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Cite This Study

Cui et al. (2026) studied this question.

synapsesocial.com/papers/69731022c8125b09b0d1fe71https://doi.org/10.3390/healthcare14020268
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