Clinical Pharmacists Intervention to Optimize the Management of a Patient with Chronic Hepatitis B: A Case Report

Hepatitis B infection is caused by the hepatitis B virus which infects the liver leading to hepatocellular inflammation and necrosis. Infected persons can either present with acute or chronic disease. Persons may also present with asymptomatic infection, mild disease, severe or rarely fulminant hepatitis. Acute hepatitis B is often associated with acute inflammation and hepatocellular necrosis, usually self-limiting. Chronic hepatitis B infection is however defined as persistent hepatitis B virus infection, which is the presence of detectable hepatitis B surface antigen in the blood or serum for more than six months, with or without active viral replication and evidence of hepatocellular injury and inflammation. We present a case of a young African adult male with chronic hepatitis B infection who reported to the community pharmacy to purchase medication. Upon further questioning, pharmaceutical care issues identified by the clinical pharmacist included the need for initial patient assessment, clinical evaluation and laboratory investigations at a hospital before recommendation of medication therapy, invalid prescription, wrong choice of the pharmacological agent as first-line antiviral therapy, and the need for patient counselling. Interventions by the clinical pharmacist resulted in the patient being seen at the hepatobiliary clinic of a tertiary teaching hospital. This led to optimized patient management, positive patient outcomes and improved quality of life.

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