CASE STUDIES

Case Study: Pharmaceutical - Auto Injector Training

Background
A large pharmaceutical company came to Intuition to discuss producing
training for their auto injector pen designed to administer medication to
Hep-C sufferers. Although the device was designed to be patient-friendly
with features such as an easy-to-read dial-up dosing button for
individualized weight-based dosing, a self-priming action that
automatically removes air bubbles from the pen prior to patient self-administration and a small needle
size to minimize patient discomfort, the device still accounted for a huge volume of customer
complaints across the companys product lines.

Repeated efforts by the company to address these complaints through direct patient training sessions
with nurse practitioners, support materials, DVDs, and sales rep training sessions did not succeed in
reducing the number of complaints received since the device launched. Some of the main complaints
were:
Perception of loss of dose when the device is actuated the dose can no longer be seen in
the vial window. Coupled with some fluid being expelled along with air during priming, some
patients believe they have lost their dose, or that they may not be receiving the full dose.
Problem actuating the pen the device needs to be actuated against a non-slip flat surface to
ensure the pen clicks properly and the dose mixes properly. The pen must be held upright, i.e.
the dosing button at the bottom and the needle at the top. Some patients were trying to actuate
the pen in their hands and this could have led to actuation failure. On these occasions the
perception is that the pen is defective.
Labeling Despite the fact that the pen should be actuated standing up, the label on the pen
will be upside-down when the pen is stood this way, and this seemed to be confusing people. It
may have been leading them to handle the pen in a different way.

During our needs analysis it became clear that there had been no shortage of effort by the company
to address the issues as outlined above. However, even though time, money, and resources had
been spent trying to address these issues, the volume of complaints received had not been reduced.
As new patients started using the device the same complaints arose again and again.


CASE STUDIES

Approach
Intuitions perspective was not that the existing materials were redundant, but that a complementary
learning initiative, probably from a different teaching perspective, needed to be identified and
implemented to make real progress on reducing the complaint numbers for the device.

Intuition proposed a solution intended to reduce the number of complaints received by the company
on the device. We believed that in the initial patient learning phase, getting to grips with the key
procedures in the multi-step process of using the device
was seen as complex. Added to that was that a typical
patient would only use the pen on a weekly basis, thus
there was no embedding of information rapidly over the
initial period. The solution aimed to push patients
through a quick learning curve so that they would
develop confidence and ease with the device. Support
material offered a quick summary of key tasks and steps.

Intuition produced an engaging web-based eLearning module, approximately 10 minutes in length,
that taught patients and the medical practitioners who initially instruct them in a simple and direct
manner regarding how to use the device and avoid the most common problem areas or areas of
confusion. Content was direct and accessible and mirrored the 4 key stages (Mix, Attach the Needle,
Dial, Deliver) for delivering the medication covered in the existing training DVD and instruction
materials Additionally, we recommended several changes to product labeling and marketing
materials, which the company adopted.

Outcome
The outcome was dramatically lowered complaints from new patients, along with increased sales of
the product.
We applied the following principles in designing the product training:
Consistency of Message Key to the effectiveness of the
learning and information interventions was the creation of
consistent uniform messages and information. Each of the
delivery modes reflected and mirrored each other so that the
patient received the same simple and direct message again
and again in all collateral related to the product.



CASE STUDIES
Reduction of Cognitive Overload Cognitive overload occurs when there is excessive
demand made on the cognitive processes in particular memory. This can occur when the mind
attempts to gather and hold too much information or detail. The eLearning product produced
by Intuition took the content delivered on the existing training DVD and taught it so that no
cognitive overload occurred in the learners mind. The information was structured and
sequenced into small nuggets and steps so it became memorable. The learning intention was
to use a variety of learning devices a simple, strong message on how to mix, attach the needle,
dial and deliver the dose.

Redundancy This is the principle of duplicating the message in order to avoid transmission
errors. We offered the same message in different ways in different places so that the key
messages and content would be assimilated into long term memory through consistent
repetition. Thus the eLearning taught the 4 steps clearly and directly, the place mat offered a
concise aide-memoire to consult when using the pen, and the medication information reflected
the exact same stages on initial reading of this information.

The outcome was a tightly focused DVD-based course and a uniform message in all supporting
materials. 3D animated models of the device were used against clean and uncluttered backgrounds to
avoid distractions and focus directly on the key learning points for the device. The simple language
and sympathetic audio narration, combined with the focused four-stage message, led to an engaging
and effective course designed to quickly teach correct use of the device and aid retention of that
learning over repeated uses of the device. The DVD was included in the blue bag startup kit for new
patients.

Additional Recommendations to the client
In addition we recommended to our client that other changes be made to complement the educational
approach, namely:
Making changes to language and formatting and also adding a FAQ section to the place mat
supplied as part of the startup kit.
Modifying the labeling on the pen device.
Adding labels to the dosing tray supplied as part of the startup kit.
Reorganizing and reformatting parts of the Medication Guide that is supplied to new patients.

Together, the changes we suggested contributed to increased sales, along with dramatically lowered
complaints over time, as the training and other changes were implemented.