This document provides guidelines for experience meetings and dinner debates aimed at doctors to discuss the drug Zelmac. The objectives are to share positive experiences with Zelmac to gain doctors' confidence, discuss ways to better identify IBS-C patients, and encourage doctors to prescribe Zelmac for more patients. Meetings should have 6-7 minimum attendees, at least 70% of whom have positive Zelmac experience. Moderators must be gastroenterologists who advocate for Zelmac and have excellent presentation skills. Meetings will follow a case study approach, with representatives following up after to evaluate changes in doctors' attitudes and prescribing habits.

1. Experience Meetings/ Dinner Debates Guideline
• Objectives:
Through discussions with peers ensure doctors:
- share positive experiences with Zelmac to gain dr’s confidence
- discuss ways to better identify C-IBS patients
- challenge dr’s to consider Zelmac for more patients
• Audience:
- Min of 6-7 and max of 12-15
- At least 70% have a positive experience with Zelmac
- All dr’s have tried at least one patient on Zelmac
- 1 or 2 moderators and A dr’s only
• Criteria for Moderator:
- Gastroenterologists whose an advocate for Zelmac
- Credibility amongst the dr’s
- Excellent present skills and English language
• Structure Outline:
- Case Study Approach ( moderator needs to have at least 3 cases
prepared)
- Refer to question guide
- Ensure summary/conclusion at the end
- Reps Follow-up Critical
• Evaluation:
- Change in dr’s attitude and RX habits after the meeting
• Don’ts
- Mix GP’s/Specialists at the same meeting
- Have an unprepared moderator
• Do’s
- Listen & Learn – this is where you can really see where your dr is on
the A to B shift.
- Follow up dr’s on key points raised
- Ensure your FLSM/ Medical Manager or BM is present at the meetings
- Brief the moderators at least 1 week before the meeting
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2. Moderators Dinner Debate Outline:
• Before you approach the moderator you need to answer the following
questions:
(1) What is the purpose/outcome you want? e.g. Better Diagnosis of IBS or just c-
IBS? Targeting the right patient for Zelmac, Gaining dr’s confidence by
sharing success stories and answering their queries etc.
(2) What is the best format e.g. presentation then discussion on the topic or
through case studies.
(3) If case Studies then they need to be balanced – have at least one which isn’t
suitable for Zelmac to ensure they get the right patient type.
(4) What resources do you need from FLSM/BM ?
• The Actual Meeting:
(1) Welcome dr’s to the meeting and state the purpose of the meeting; to have a
discussion on e.g.:
- Better diagnosis of the IBS patient
- Current Treatment options
- Share feedback and experience with Zelmac
(2) Then go through the agreed format either case studies or sharing of
experiences.
(3) Moderator asks appropriate questions. Group discusses the points. Ensure the
moderator is briefed on what sorts of questions to ask.
(4) Summary/close – Key Learnings, follow-up.
• Do’s:
- Ensure you Moderator is well briefed and has positive experiences with
Zelmac
- For your first few meetings have either your BM/FLSM/CM/MM at the
meeting. Don’t do it alone.
- Get Medical involved – they can add a lot to the discussions during the
meeting
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3. Question Guide:
• To help recognize IBS as a real medical disorder:
- What can you tell me about IBS?
- What do you believe is the cause of IBS?
- How often do you see patients with abdominal pan/ discomfort,
bloating or constipation?
- Do you consider abdominal pain /discomfort, bloating and constipation
as a group of individual symptoms or as a single disorder?
- How often do you regularly treat female patients for abdominal pain
and/or constipation, yet the symptoms always return?
• To help recognize the IBS-C patient?
- Do you have patients who you see repeatly complaining of the same
symptoms?
- Do you see patients who have come to you because the abnormal pain
is unbearable?
- Do you have patients who complain that their bloating is so bad that
they battle to fit into their clothes?
• To help positively diagnose IBS-C?
- How do you currently establish a diagnosis of IBS-C?
- Do you worry that you may miss something when you diagnosis IBS-
C?
- Do you refer patients who you suspect have IBS-C?
• To help dr’s who diagnoses IBS-C and treats with diet/lifestyle and
traditional therapies
- What do you usually recommend to your IBS-C patients
- (If this option fails, what is the next step)?
- Have you followed up patients treated with diet and lifestyle
modification?
(Are they satisfied? compliant? self-medicating?)
- Do you target just one symptom with the treatment?
- To treat multiple symptoms do you prescribe combination therapy?
- Do your patients ever complain of symptoms other than bowel
frequency?
- Do you find that medications for one symptom sometimes aggravate
another symptom?
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4. • To help the dr who uses Zelmac in the same way as they use an
antispasmodic or laxative
- How long do your RX Zelamc for?
- Why would you RX Zelmac for 7 days only?
- How do you describe how Zelmac differs from traditional therapies to
your patients.
- How do you explain the Zelmac dosing Schedule to your patients?
• On Zelmac
- What would stop you from using Zelmac 1st
line in appropriate patients
with IBS-C?
- What experiences have you had with Zelmac?
- What patients have you treated?
- What did you patients say about Zelmac?
- What differentiates Zelmac from other agents you use?
- In which patients do you see your best results with Zelmac?
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