*4.4.2 Peer review*

The CF Patient Passport was then presented to CF nurse specialists, CF physiotherapists and respiratory consultants for review. During this review, the app purpose, aesthetics, dialogue, content, and functionality was reviewed. Slight modifications are recommended by the reviewers to improve the quality of data entered and prevent errors. Examples of this feedback included the incorporation of a drop-down menu which contains all possible bugs that can be growing in mucus as opposed to the patient manually entering this data. Similarly, in places where

patients must enter a date range (*e.g.* start date and end date) it should be possible for the user to enter just a month and year as opposed to date, month, and year. Overall it is agreed that the CF patient passport can be of benefit to CF adult patients as it will allow for this cohort to always have access to their basic medical data and become more aware of their own condition and symptoms.

asked to explain their answer, the participant who reported a 3 did not elaborate further. However, two other participants remarked that the app is helpful as it

was beneficial to have access to their basic medical information through the app. When asked who the participants believe is responsible for inputting data into the

participant believed it was the shared responsibility of the participant and their CF treatment team. The users were then asked to explain their answer. It was found from these answers that users believe it is their responsibility as entering data should be at their discretion. However, one participant welcomes guidance from

*"Personal info on a personal device should only be entered by the owner unless explicit permission is given. I think I am ultimately responsible for knowing about my condition and recording the information but I might not always know the most important information to be recorded which is why my nurses and doctors should*

*"It's my app and on my phone, so it's my own responsibility to keep it updated"*

being Regularly). Two participants rated this question a 1, one participant reported a 3, and the remaining participant reported a 4. When asked to list scenarios in which they felt the app maybe useful, the participants reported the following

*"Sharing information with my GP or if I'm traveling and need to share information*

It can be seen from the above scenarios that participants felt that the app maybe of most benefit when travelling abroad or sharing information with medical and healthcare professionals. Lastly, the participants were asked to rate how adequate the security precautions within the app are from 1 to 5 (1 being not adequate and 5 being adequate), to which two participants rated a 5, and the remaining two

It is acknowledged that some limitations of this study are the small number of participants and the disproportionate ratio of male to female participants, which could present a potential gender bias. There was a notable difference in the participants reported regularity of the apps use. Patients were asked about how often they

One participant reported a barrier which prevented the editing of data. This participant found that some saved data in the My CF Info section of the app could not be edited, and instead needed to be deleted and inputted again, which they regarded as frustrating. The participants were then asked to rate the regularity of using the app from 1 to 5 (1 being Not Regularly, 3 being Sometimes, and 5

app, three participants reported that the responsibility is theirs, while one

This is further enforced in Question 10, where all participants agreed that it

*"It's useful to have this information in an easily accessible place" "It's handy for me to have my information so readily accessible"*

allows them access to their medical information:

*DOI: http://dx.doi.org/10.5772/intechopen.85512*

*Designing Heterogeneous-mHealth Apps for Cystic Fibrosis Adults*

*"I put what I think is necessary"*

*"If I got sick on holidays could show what I'm on" "Listing medication/medical details at clinics etc"*

*with a doctor. Going abroad or another hospital/GP"*

their healthcare team.

*also have input."*

scenarios:

rated a 4.

**119**

**5.1 Initial observations**

#### *4.4.3 Patient review*

Following on from the stress test and peer review, ethical approval was granted by the Clinical Research Ethics Committee in the University College Cork for pilot testing with CF adults from the Cork University Hospital. The inclusion criteria for this study was that patients must be 18 years old or older and own an Android smartphone. Participation in this study was voluntary and was offered to patients during clinical appointments over two consecutive days. Five eligible patients were identified and recruited by the CF nurse specialists. All five patients agreed to partake in the study; one participant was female and the remaining four were male. Each participant was provided with an information sheet outlining the purpose of the app, the data collected, intentions for the data, and security measures. After the app was installed on their devices, the participants partook in a short workshop with the CF nurse specialists, who demonstrated how to use the app. The CF nurse specialists also assisted the participants in entering any of their historical or patient file data into the passport app. The patients were then asked to test the app over 3 months before completing a feedback questionnaire, which was provided to them at their next closest clinical appointment.
