Case Study: Expanding Availability of Healthcare Services
Janssen eMedical Advisor (JeMA) Platform for Sub-Saharan Africa, Janssen, the Pharmaceutical Companies of Johnson & Johnson
Janssen eMedical Advisor (JeMA) platform is a new training tool designed to address the lack of on-demand product information resources for healthcare providers (HCPs) in Sub-Saharan Africa (SSA). JeMA offers videos, PowerPoint slides, product inserts, and other Janssen HIV medicine–related resources in both English and French. It was specifically designed for optimized use in the SSA environment, including low bandwidth internet connections, and is accessible to HCPs at any time to allow for learning at a provider’s own pace and schedule.
After a country’s health authority approves Janssen’s HIV products, healthcare professionals in SSA can access the website content, allowing them to become familiar with the products prior to and during patient management. It also allows them to promptly respond to phone queries about the product after patients have left the health facility with the medication bottle and product insert documents.
The most widely accessible Janssen HIV medications in SSA to date are the adult tablet formulations of darunavir (Prezista, 300 milligrams) and etravirine (Intelence, 100 milligrams). These medicines are largely included in most country’s national antiretroviral treatment guidelines for the management of third-line, heavily-treatment-experienced patients following the World Health Organization (WHO) guideline recommendations for third-line treatment options.
JeMA is a new product-information training tool designed to meet the needs of HCPs in SSA while also addressing the tight industry and regulatory requirements for proactive provision of on-label product information to appropriate health personnel.
JeMA is an online platform providing videos, PowerPoint slides, and product inserts for HCPs in both English and French as presented by Janssen Medical Affairs individuals, easing the many resource challenges of engaging in face-to-face meetings at the country- and health institution–levels within the region. HCPs can better relate to the presenters (employees of the drug manufacturer) because they can listen to the presentations repeatedly if needed. Focusing on specific company products is still an important approach to informing HCPs about the posology of medications in SSA, where registration studies are undertaken in a limited number of countries, oftentimes resulting in delays in the region’s awareness of new medications.
JeMA is a new tool that will continue to evolve to specifically suit the needs of HCPs in SSA. Constant troubleshooting based on user feedback is the cornerstone of improving its relevance as a reference tool. More countries will be granted access as health authority approvals come through, and the content will be regularly revised with updated information about more Janssen products as the regulatory documents are upgraded.
Results to date?
Quantitative data points:
- Access to either darunavir (Prezista, 300 or 600 milligram tablets) or etravirine (Intelence, 100 milligram tablets) or both medications, which are commonly prescribed for management of highly-treatment-experienced HIV patients, is possible in at least 21 countries in SSA based on local health authority regulatory approval.
- Africa, healthcare professionals from eight SSA countries registered to use it by the end of the first quarter of 2014.
- Eighty-four unique visitors requested pages from the website during the period from December 2013 through March 2014, with 148 total visits. The most frequently visited parts of the website included the product inserts page and the PowerPoint slides on the medication darunavir.
- The percentage of new visits during the same time period was 67 percent; the rest were returning visits. Most of the visitors have been SSA-based HCPs from South Africa, Botswana, Zambia, Zimbabwe, Uganda, Kenya, Senegal, and Ghana.
Qualitative observations undertaken in the field among some registered users suggest that:
- Most users request information on the medication darunavir because it is used as the protease inhibitor backbone drug for construction of a third-line, salvage regimen in SSA countries where such a level of patient management exists. Due to stringent guidelines for these third-line medications, only select HCPs have ongoing experience with their prescription or patient monitoring.
- Most users’ internet access during daytime and peak working hours can largely support their viewing of the documents posted on the website, but their connections are not fast enough for streaming videos despite a built-in adjustment for low bandwidth. Future adaptations may include audio recordings (without video) in order to overcome such limitations.
- Access to the website enables HCPs to get information when they need it, both during a clinic appointment and after the patient has left the health facility with the medication. HCPs no longer have to rely solely on the printed product insert in the medication packaging.
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