# 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

## TL;DR

This study explores what helps or hinders older COPD patients from using AI agents to manage their chronic disease.

## Contribution

The study applies normalization process theory to identify facilitators and barriers of AI use in COPD management among older patients.

## Key findings

- Four main themes and 18 subthemes were identified as facilitators or barriers to AI agent use.
- Facilitators include recognition of AI, family atmosphere, and support from healthcare providers.
- Barriers include privacy concerns, trust issues, and technical anxiety.

## 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.