This study evaluated the differential characteristics between Chronic Obstructive Pulmonary Disease (COPD) exacerbator patients who accepted or declined participation in a telemonitoring program based on the virtual assistant “Lola” at Virgen Macarena University Hospital (HUVM). Between October 2023 and November 2024, 82 patients were invited to participate, and clinical as well as sociodemographic variables were collected through electronic health record review and telephone interview. Of these, 59.8% agreed to participate, whereas 40.2% refused. Refusal was significantly associated with lower sociocultural level, fewer electronic devices, higher anxiety and depression scores (HADS-A, HADS-D), and lower adherence to inhaled therapy (TAI). These findings suggest that sociotechnological barriers play a determining role in program acceptance and may inform patient selection strategies and implementation approaches aimed at improving adherence and optimizing the effectiveness of telemonitoring interventions.
