A New Model for Hepatitis B Care: Pilot Evaluation of a Virtual Messaging Pharmacist led Service

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Lau E.
Dearden J.
Jones, A.

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2025

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Hepatitis B remains a global health concern, with an estimated 1.2 million new infections occurring each year.1 This growing number of patients places significant pressure on services, resulting in overbooked clinics and prolonged waiting times for new patients. A pilot virtual messaging, pharmacist-led service was implemented as a proof of concept to demonstrate safety and effectiveness before wider rollout, with the longterm goal of improving clinic efficiency and capacity. Patients with chronic hepatitis B (CHB) under the pharmacist- led hepatitis clinic at Whipps Cross Hospital who are stable on antiviral therapy were offered virtual messaging followup appointments via the NHS-accredited Accurx messaging system, alternating with telephone consultations, at 6-month intervals. The patients were followed up for a period of 16 months. Data on medication adherence, appointment attendance, and HBV DNA levels were collected between January 2024 to May 2025. Patient satisfaction was assessed through a survey, and medication records were verified through the hospital outpatient pharmacy. A total of 21 patients were included in this pilot study. The median age was 50 years, with 7 female (33.3%) and 14 male (66.7%) patients. 7 patients are on entecavir (33.3%), and 14 patients are on tenofovir disoproxil (66.7%). Full medication adherence (100%) was achieved across the cohort. Blood test attendance within the last 6 months was recorded for 18 patients (85.7%), while the remaining 3 patients (14.3%) attended within the last year. All patients maintained undetectable HBV DNA levels. 12 patients (57.1%) responded to the patient satisfaction survey. Of those, 11 patients (91.7%) reported high satisfaction with the service provided, and all 12 patients (100%) expressed willingness to continue with virtual messaging follow-ups. Over the course of the pilot, an additional 42 appointment slots were freed up for new patients. This pilot serves as a successful proof of concept for a pharmacist-led virtual messaging service for hepatitis B followup, showing safety, high patient satisfaction, and potential to improve service delivery. Despite the small sample size, these findings support virtual reviews as a promising alternative to traditional outpatient care, with plans to expand the service and recruit more patients over the coming years. This model could help address increased demands on hepatology services and may be adapted to manage other chronic liver conditions.

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