This study presents a novel physio-pharmacological framework for assessing the potential performance-enhancing effects of substances and methods included in the 2022 World Anti-Doping Agency (WADA) Prohibited List across 160 Olympic sport disciplines. An expert panel evaluated 31 consolidated pharmacological categories for their capacity to enhance performance across six core physiological athletic demands. Using a calibrated scoring function and bilinear interpolation, we mapped these effects to each sport's dominant physiological profile. Findings confirmed the well-known ergogenic effects of anabolic agents and erythropoietins for power and endurance-based sports, respectively, including the general ergolytic effects of narcotics and cannabinoids. Moreover, the methodology can be used to evaluate any new sport or substance given their respective physiological demands. The study underscores the need for targeted anti-doping strategies, suggesting that risk assessment and test distribution planning should be aligned with sport-specific physiological demands and the relative performance advantages conferred by different doping strategies. This summary of the current physiological knowledge and pharmacological knowledge has the potential to enhance detection efficiency, optimize resource allocation, and refine prohibited substance screening in elite sport.

BACKGROUND:During the Tokyo 2020 Games, pharmacists were required to provide appropriate pharmacotherapeutic care to athletes and officials at the polyclinic. Owing to the worldwide COVID-19 pandemic that was prevalent at the Games, it was imperative to strengthen infection control measures in the setting of such a major sporting event and to prevent and minimize the spread of COVID-19. OBJECTIVE:This study reports on the COVID-19 infection control measures and services provided by the pharmacy at the Tokyo 2020 Games. By evaluating pharmacy operations that took place under the COVID-19 protocol, this study provides insights for the organization of future sporting events, specifically their medical facilities. METHODS:Infection control measures in the pharmacy were implemented in accordance with the manual for dealing with COVID-19 infections. The number and content of issued and dispensed prescriptions were obtained from the electronic medical records and pharmacy department systems. These data were compared with those of the London 2012 Games, which were used as a reference for the pharmacy operations at the Tokyo 2020 Games. RESULTS:The participating pharmacists were fully trained in infection control measures. The number of prescriptions issued during the Olympics and Paralympics were 1120 and 1022, respectively. Prescriptions issued at the fever clinic accounted for 4% of the total number (77/2142). No influenza antiviral medications were prescribed, though medications to alleviate cold-like symptoms were issued. Compared to the London 2012 Games, there was a decrease (-59%) in the number of prescriptions. CONCLUSION:The positive impact of COVID-19 infection control measures was evident. The volume of prescriptions at the Tokyo 2020 Games was lower than that at the London 2012 Games. It was inferred that this was due to thorough infection control measures as well as enhanced pre-entry medical checkups before entering Japan, which reduced the incidence of diseases.

Objectives To evaluate the awareness of the volunteer pharmacy workforce of medication use and their satisfaction with the pharmacy services of the Tokyo 2020 Olympic and Paralympic Games from a pharmacist’s perspective. Methods A questionnaire was developed from related articles in published peer-reviewed journals and modified prior to distribution to the whole population of pharmacists serving at the Tokyo 2020 Olympic and Paralympic Games. Validity tests were conducted based on expert opinions and Cronbach’s alpha (0.79). The questionnaire consisted of demographics (11 questions), knowledge of medication use in sports (8 questions) and satisfaction on the provision of the service (5 questions). Responses using a 5-point-Likert scale, from strongly agree (5) to strongly disagree (1), and two free text questions were analysed with descriptive statistics. Results The response rate was 86% (n=32/37). Overall, the pharmacists reported a high awareness of medication use. Specifically, questions on the prohibited list of medications (mean 4.0±SD 0.7), COVID-19 policy (3.8±0.9), use of alternative non-prohibited medications (3.6±1.0) and therapeutic use exemptions (3.5±0.9). Moreover, they rated high satisfaction with the pharmacy service they provided. However, rates were ≤3 for knowledge of the International Olympic Committee Needle Policy (2.6±1.0), Medication Importation Declaration (2.9±1.0) and communication skills (3.0±1.0). Conclusion Pharmacists were confident and satisfied with the pharmacy service at the games. The study confirms the importance of prior training and education. Game-specific policies and strategies to improve communication skills should be included in the pharmacy education for future Games.

Objective Pharmacy services at large multisport events support safe and effective medication use. Our aim is to describe the contribution of pharmacists and to share the pharmacy experiences at the 2018 PyeongChang Olympic and Paralympic Games. Methods The data collected included the accreditation details of patients and prescribers indicating: sport, country, athlete or non-athlete status, and prescription details including: medication, strength, frequency, length of treatment, for the period of the Olympic Games (1–26 February 2018) and the Paralympic Games (5–20 March 2018). The numbers of prescriptions dispensed were analysed by medication category, sports and country of the patient. Results A total of 5313 medication items were dispensed over the course of the Olympic and Paralympic Games (athletes: 670; non-athletes: 4615; unknown: 28), for a total of 2360 patients. 72 of 82 countries (87.8%) had fewer than 20 patient visits. The first high peak (Olympic: 5.0%; Paralympic: 7.3%) of daily volume of prescriptions were dispensed in the 2 days prior to the Olympic and the 1 day prior to Paralympic opening ceremonies. Therapeutic Use Exemption (TUE) and International Olympic Committee NeedlePolicy were well managed and compliant with the regulations. Conclusion Pharmacy services at major multisport games include dispensing over 5000 prescriptions, supporting the TUE and IOC Needle Policy processes and providing clinical information to athletes and prescribers on drugs in sports and the World Anti-Doping Agency regulations of drugs prohibited in sport. During the PyeongChang 2018 Olympic and Paralympic Winter Games, pharmacists played a crucial role in delivering safe and effective pharmacy service based on their expert knowledge in antidoping and the clinical use of drugs in sport.

The International Olympic Committee has recently launched the IOC Certificate in Drugs inSport. This review outlines the current need and learning objectives of the course, which has been developed for healthcare professionals and other athlete support personnel who require specialist knowledge and understanding on the use of drugs in sport.1 The postgraduate-level 6-month online course aims to protect the health of the athlete by ensuring medicines and supplements are used in a safe and effective way. It primarily focuses on the medical aspects of drug use in sport with emphasis on the role of healthcare professionals in the prevention of doping. Healthcare professionals are often the first people consulted by athletes on issues relating to drug use, from both clinical and antidoping perspectives. Athletes may require advice on the drug treatment for acute or chronic medical conditions, the pharmacological management of sport injuries, the use of dietary or ergogenic supplements, or the status of treatment according to the WADA List of Prohibited Substances and Methods.2 The World Anti-Doping Code recognises that healthcare professionals should play a significant …

BACKGROUND AND PURPOSE:The use and misuse of drugs in sport is becoming increasingly important globally, and the role of pharmacists is evolving in this regard. This paper describes the design and implementation of an elective course "Drugs in Sport" in an undergraduate pharmacy curriculum.EDUCATIONAL ACTIVITY AND SETTING:The elective course was designed to introduce BSc pharmacy students to an evidence-based approach to safe, effective, and legal use of drugs in sport. The course covered why athletes take drugs, evolution of doping in sport, the international regulations regarding doping and anti-doping in sport including the World Anti-doping Agency Prohibited List, as well as testing and monitoring for drug use in sport. It also included the role of athlete support personnel (ASP) in preventing the use of prohibited substances by athletes. A web-based survey was conducted at the end of the course to assess the students' perspectives of the course.FINDINGS:Students provided an evaluation of the course in terms of its content, methods of delivery, and assessment. Overall, the students demonstrated competence. They gained insight into international and national regulations regarding doping and anti-doping in sport and the potential role of pharmacists as ASP in providing support and advice for athletes and the public.SUMMARY:Designing and implementing an evidence-based course on the use of drugs in sport customized for pharmacy students was achieved successfully. Such courses could provide an opportunity to advance the scope of pharmacy practice and possibly provide a new career path for future pharmacists.

BACKGROUND:The aim of this study was to evaluate the current knowledge and perceptions of pharmacists in Qatar with regard to the use of drugs in sport and to explore their views on the introduction of education and training in the area of sports pharmacy.METHODS:A cross-sectional survey was conducted targeting both hospital and community pharmacists in Qatar. A questionnaire consisting of three domains pertaining to participants' knowledge, perceived role of healthcare professionals, and attitudes towards educational needs on the use of drugs in sports was developed and validated. The online survey link and paper-based questionnaires were distributed to the target population. Data analyses were performed using IBM SPSS Statistics. Descriptive and inferential statistics were utilized for the analyses, where P<0.05 indicates statistical significance.RESULTS:A total of 300 pharmacists responded to the survey. Respondents had a limited awareness of doping and anti-doping and achieved an average knowledge score of 53.2% regarding the prohibited status of drugs that may be used by athletes, particularly with respect to over-the-counter medicines and supplements. The majority (81.7%) of the pharmacists expressed an interest in receiving education and training on sports pharmacy.CONCLUSIONS:Specialized training programs are warranted to ensure that pharmacists have the knowledge and skills required to provide athletes with accurate information about anti-doping issues and the safe and effective use of medicines in sport. The development of these programs should be supported by national pharmacy policy makers and designed in collaboration with anti-doping agencies and sports pharmacy experts and educators.

Objective. To assess pharmacy students’ knowledge and perceptions of doping and anti-doping in sports and to explore the curricular needs for undergraduate pharmacy in the field of sports pharmacy. Methods. A cross-sectional, descriptive, web-based survey of pharmacy students was conducted at Qatar University College of Pharmacy from March to May 2014. Data were analyzed using descriptive and inferential statistics. Results. Eighty respondents completed the online survey (80% response rate). Sixty percent were unaware of the World Anti-Doping Agency, and 85% were unaware of the International Pharmaceutical Federation’s statement on the pharmacist’s role in anti-doping. Students’ knowledge score regarding the prohibited status of drugs that may be used by athletes was around 50%. Fourth-year pharmacy students had significantly higher knowledge scores than the other groups of students. Respondents acknowledged the important role of health care professionals, including pharmacists, as advisors on the safe and effective use of drugs in sports. Ninety percent of the students supported the inclusion of sports pharmacy in the curriculum. Conclusion. Pharmacy students indicated a strong desire to play a role in doping prevention and ensure safe and rational use of drugs among athletes. They suggested requiring an education and training strategy for sports pharmacy in undergraduate pharmacy curricula.

Objectives This study aimed to evaluate the impact and legacy of pharmacists’ professional development having worked as volunteers at the London 2012 Olympic and Paralympic Games. Methods Questionnaires were administered immediately following the Games and 1 year after the Games. The first explored motivation for volunteering, training and support and reflection on personal experiences at the time of the Games. The second evaluated the personal and professional impact that working as a volunteer has had in the year following the Games. Results Immediately post-Games, 19 of the 22 (86.5%) respondents reported that they were able to use their pre-Games education and training effectively, particularly relating to antidoping regulations. One year after the Games, respondents reported that the experience had been influential on core aspects of their practice. Close collaboration with pharmacy colleagues, other healthcare professionals and Olympic and Paralympic team doctors was reported as a significant benefit of working at the Games. Conclusions Comprehensive education and training is beneficial in providing a safe and efficient medicine service for athletes and provides a lasting legacy in terms of improving the standard of care for athletes or people participating in sport.

Medical services have been designed and implemented for a number of major sporting events in the recent years, including Sydney 20001, Athens 20042, Singapore 20103 and Innsbruck 2012.4 Within the published reports from these Games, little or no reference was made to the important role that pharmacy plays within each of the disciplines that constitute medical services. The health protection of athletes is a crucial role for the International Olympic Committee.5 It is therefore important that medical services at major sporting events, such as Olympic and Paralympic Games are well-planned, comprehensive and robust. Consequently, the London Organising Committee of the Olympic and Paralympic Games (LOCOG) were tasked with providing these services. The Medical Services for London 2012 incorporated a specialist pharmacy work stream comprising a Pharmacy Planning Committee that had an advisory and operational role for the LOCOG Medical Services. This nine-member committee, under the leadership of Mark Stuart, Pharmacy Clinical Lead, brought national expertise and experience from across the sphere of pharmacy practice. A recently published paper details the work of this committee in developing and delivering pharmacy services for London 2012.6 The objective of the present review was to evaluate the impact of a number of innovative features in the pharmacy services that had not been operated at previous major sporting events. The primary remit of the Pharmacy Planning Committee was to design and oversee a safe, efficient and accurate dispensary service and to plan a system of supply, storage and management of medicines for use at competition and training venues. This included the design of systems to manage a range of drugs used for emergency medicine, including controlled drugs (morphine sulfate) that were carried by doctors at the competition venues. In collaboration with the other LOCOG specialist clinical leads, …

The London Organising Committee for the Olympic and Paralympic Games was established to plan and deliver the London 2012 Games. Within the Medical Services network, the Pharmacy Planning Committee (PPC) developed and delivered pharmacy services that were among the most advanced and comprehensive of any Games. The PPC designed a pharmacy service according to UK standards, operated through three polyclinics at the Athlete Villages. From these polyclinic pharmacies a system was set up for the supply, storage and management of medicines for use at all competition and training venues. To ensure safe and standardised approaches were used, a comprehensive set of policies and standard operating procedures was developed. Pharmacy guides, including drug formularies, were provided for the medical prescribers both within the polyclinics and as members of the Olympic and Paralympic Teams visiting the Games from around the world. Over 100 pharmacists and pharmacy technicians were recruited as the volunteer workforce for the Games. A training and education programme was developed to prepare this team to work in the unique environment of an Athlete Village polyclinic. A total of 5200 prescriptions (6849 items) were dispensed through the polyclinic pharmacies over the period of the Games. In addition, a Pharmacy Minor Ailments Scheme for non-athletes was introduced for the first time at an Olympics, with 1046 encounters taking place over the period of the Games. Valuable lessons were learnt from developing and delivering these pharmacy services. These have been reported back to the International Olympic Committee to ensure continued development and improvement of pharmacy services at future Games.