Research Appraisalqualitative

Exploring Patient Perspectives on the Use of Artificial Intelligence to Inform Joint Decision-Making for Patients With Multiple Conditions in Primary Care in the United Kingdom: Qualitative Study

Journal of medical Internet researchFlanagan, Sarah, Spurway, Charlotte, Jackson, Louise et al.21 Apr 2026DOI

Clinical Snapshot

85CEBM
Evidence: Moderatequalitative

PICO Framework

P — PopulationAdults living with multiple long-term conditions (MLTC) in the United Kingdom
I — InterventionArtificial intelligence-assisted decision-making tools in primary care
C — ComparatorCurrent standard care without AI assistance
O — OutcomesPatient perspectives, attitudes, concerns, and acceptance regarding AI use in shared decision-making

Bottom Line

This qualitative study of 29 UK adults with multiple long-term conditions reveals cautious optimism toward AI-assisted decision-making in primary care. Patients recognized potential benefits including improved consultation efficiency, better access to information, early detection of health changes, and reduced healthcare inequalities. However, significant concerns emerged regarding loss of human interaction, data privacy and security, algorithmic transparency, and potential for bias. Trust and acceptance varied by age and technology familiarity, with some participants uncertain about AI capabilities. For Australian clinicians considering AI implementation, this research highlights the importance of addressing patient concerns through transparent communication, robust privacy protections, and ensuring AI supplements rather than replaces human connection. The findings suggest successful AI integration requires careful attention to patient education, digital literacy support, and maintaining the therapeutic relationship central to primary care.

Evidence: Moderate

Key Findings

  • P Value: Not applicable for qualitative research

  • Effect Size: Not applicable for qualitative research

  • Primary Outcome: Mixed patient perspectives on AI-assisted decision-making with cautious optimism

  • Nnt Or Sensitivity: Key themes: benefits (efficiency, accuracy, access), concerns (privacy, human interaction, bias), trust varies by age/technology familiarity

  • Confidence Interval: Not applicable for qualitative research

Clinical Application

Moderate - requires careful implementation addressing patient concerns about privacy, transparency, and maintaining human connection Highly relevant to Australian primary care given similar healthcare system structure, RACGP digital health initiatives, and increasing multimorbidity prevalence Adults with multiple long-term conditions in primary care settings

Abstract

BACKGROUND: Multimorbidity, living with 2 or more long-term health conditions, is increasing globally and now affects over one-quarter of adults in England. People with multiple long-term conditions (MLTC) face complex health and treatment challenges, often experiencing fragmented care within systems oriented toward single-disease management. Artificial intelligence (AI) has the potential to support clinicians and patients by analyzing complex health data, optimizing treatment strategies, and predicting disease trajectories. OBJECTIVE: The OPTIMAL (Optimizing Therapies, Disease Trajectories, and AI-Assisted Clinical Management for Patients Living with Complex Multimorbidity) project aims to develop AI-enabled tools to support shared decision-making in primary care. This study explored how patients with MLTC perceive the use of AI to inform joint decision-making in primary care. METHODS: Semistructured interviews were conducted via telephone or video call with 29 adults living with MLTC between July and November 2023. Participants were recruited through general practitioner practices via the Clinical Practice Research Datalink and community-based organizations across the West Midlands. Interviews were transcribed verbatim and analyzed thematically using an inductive approach. Members of a patient advisory group were involved in developing study materials, refining the interview guide, and reviewing emerging findings to ensure relevance and authenticity. RESULTS: Participants identified potential benefits of AI in enhancing consultation efficiency and accuracy, improving access to information for patients and clinicians, promoting early detection of health changes, and reducing health care inequalities. However, concerns were raised about the loss of human interaction, data privacy and security, transparency of algorithms, and the potential for bias and inequity in AI systems. Trust and acceptance varied by age and familiarity with technology. Some participants expressed uncertainty about what AI entails and how it could be used in primary care. CONCLUSIONS: Patients with MLTC viewed AI-assisted decision-making in primary care with cautious optimism. While many recognized potential benefits for coordination and personalization of care, others expressed reservations about privacy, fairness, and the risk of diminished human connection.

References

  1. 1.Flanagan, S., Spurway, C., Jackson, L., Cooper, J., Crowe, F. L., Haroon, S., Marshall, T., Fitzsimmons, L., Hathaway, E., Nirantharakumar, K., Jackson, T., & Greenfield, S. (2026). Exploring patient perspectives on the use of artificial intelligence to inform joint decision-making for patients with multiple conditions in primary care in the United Kingdom: Qualitative study. Journal of Medical Internet Research. https://doi.org/10.1136/bmjhci-2021-100450
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