Exploring the Knowledge, Attitude, Perceptions, and Practices of Pharmacists with Regards to Doping and Medication Use in Sports

Abstract

Background: Sports medicine has become a more prominent field of specialization in recent years, with growing interest in appropriate medication use in athletes. However, pharmacists appear to have little involvement in sports medicine. Pharmacists are optimally skilled to manage medication-specific needs of patients and should play a more pertinent role in managing the use of medication in athletes. Efforts should consider the unique physiology and lifestyle of an athlete and align with World Anti-Doping Agency regulations. Limited literature reports on South African pharmacists’ perception or interest in this field, and the hindrances to potential involvement in sports medicine.

Aim: The aim of the study is to explore the knowledge, attitudes, perceptions, and practices of pharmacy personnel with regards to medication use and doping in athletes, to better inform future actions and guidelines in South Africa.

Method: An explanatory mixed-method research design was utilized to meet the objectives of the study as approved by the University of the Witwatersrand Health Research Ethics Committee. The initial quantitative phase relied on data collected through self-administered surveys completed by pharmacy personnel currently working in community pharmacies in Gauteng. The results were analysed and displayed through various means including descriptive statistics as well as Student T-test, ANOVA, and Kruskal-Wallis tests. The qualitative phase followed, relying on information collected through interviews, with the assistance of a semi-structured interview guide, with participants from the initial quantitative phase. These responses underwent thematic analysis to extract meaningful data.

Results: A total of three hundred and thirty-two pharmacy personnel participated in the survey. The knowledge, attitude and perceptions, and practices scores obtained indicated that while participants have a positive opinion of sports medicine and pharmacy’s involvement in the field, with a mean score of 67% with regards to attitude and perception, barriers may exist that have affected participants’ opinions regarding their involvement. Participants’ self-declared knowledge received a mean score of 51%, which appears comparable with other studies. However, the tested knowledge of participants indicated much poorer knowledge with a mean score of 37%, suggesting possible poor education on the topic of sports medicine. Participants’ current practices with regards to sports medicine appeared to be limited with a mean score of 50%. The extent of involvement can be associated with the indicated limited knowledge and possible resultant lack of confidence in the field. Correlations indicated that qualification and associated professional affiliation have a significant impact on participants’ knowledge, attitude, perceptions, and practices related to doping and medication use in athletes.

These results were further emphasised during the interview process. Seventeen pharmacists participated in the qualitative phase. Pharmacists have awareness of, and a positive perception towards the field of sports medicine, and agree that pharmacists can have an impact on anti-doping efforts and appropriate medication use. Specific limitations have hindered their involvement thus far. The most significant limiting factor to pharmacist involvement in sports medicine identified was limited knowledge, resulting in poor counselling and assistance on issues related to sports medicine. Additional limitations that have a notable impact were related to the regulation of supplements causing decreased involvement by pharmacists, as well as the outward perception of pharmacists’ potential impact. The positive response to the proposed implementation of specific local guidelines or courses related to sports medicine provides an indication of pharmacists’ willingness and interest to become better educated in the field, leading to increased confidence and thus involvement.

Conclusions: The findings of this research confirmed pharmacist potential impact in sports medicine while alluding to specific problems that have hindered their involvement. With increased educational opportunities, the inclusion of appropriate resources, and efforts to include pharmacists in matters related to medication use in athletes, specifically in anti-doping, pharmacists can have a significant impact on the future of sports medicine.