The Evolving Role of Pharmacists in Sports and Exercise Medicine
The role of pharmacists in sports and exercise medicine has been upgraded and seen significant transformation in the past few years, forced to rethink pharmacy services through and following the pandemic. This shift carved new paths for pharmacy practice, and is fostering innovation and collaborative agreements that leverage the expertise of pharmacists. Concurrently, there have been notable advancements in athletes' rights and athletes' engagement as informed consumers of medications and dietary supplements. To explore these developments, we'll highlight pharmacists' emergence as key players to support sports and exercise medicine, the progression of collaborative agreements, the advocacy of athletes' rights, and the increasing awareness among athletes about safe medication and supplement use.
Advancements in Pharmacy Practice in Sports Medicine
In recent years, pharmacists have increasingly been recognized as vital contributors to the interprofessional sports medicine team: orthopedic physicians, primary care providers, sports dieticians, physiotherapists, physical therapists, mental health specialists, and other athlete support personnel. The pharmacists provide a valuable perspective with expertise in medication management, drug interactions, and evaluating therapeutic outcomes. These clinical skills positions sports pharmacists as another line of defense and a remarkable frontline offensive player in optimizing athletes' health and performance.
One of the significant advancements is the increased involvement of pharmacists in the management of reducing adverse drug events in sports, avoiding accidental doping through more selective pharmacotherapy use, and reducing the rate of sports-related injuries or aiding in recovery planning. Sports Pharmacists can collaborate closely with medical athlete support personnel to develop comprehensive treatment plans that consider the athlete's overall health, sport-specific issues, performance goals, and medication safety. This integrated approach is a useful step to double-check that athletes receive the best possible care while minimizing the risk of adverse drug reactions and avoiding doping violations. Sports Pharmacists actively implementation doping prevention strategies. By providing education on banned substances, reviewing medications for compliance with anti-doping regulations, and recommending safe alternatives, Sports Pharmacists help athletes recognize and avoid prescribed therapies from becoming a positive doping tests. Having a qualified sports pharmacist involved in the selection of the most appropriate pharmacotherapy for an indication has been know to reduce and ultimately eliminate inadvertent doping from prescribed or self-treatment with drugs; thus, saving the athlete from the severe consequences, expense and time lost to a doping investigation.
Collaborative Agreements and Expanded Roles
The expansion of collaborative practice agreements (CPAs) has been a pivotal factor in enhancing the role of pharmacists in sports and exercise medicine. These agreements allow pharmacists to perform specific patient care functions within their scope and skillset; thereby, expanding athletes' access to care and increasing patient-athlete monitoring to improve outcomes.
In the context of sports medicine, CPAs have empowered Sports Pharmacists to conduct medication therapy management (MTM) services, prescribe medications within their scope of practice, monitor therapeutic outcomes, conduct focused physical assessments, educate and implement use of medical devices or disease management tracking apps, conduct screenings for preventive care like cardiovascular or mental health screening tools, and much more. This autonomy enables pharmacists to play a more proactive role in managing chronic conditions that athletes commonly live and train with, such as asthma and Type 1 diabetes, that impact an athlete's performance and are treated with medications that may be harmful if misused or not used. CPAs also facilitate the establishment of specialized sports pharmacy services, where pharmacists tailor advice on medication use, therapeutic use of nutritional supplements, and injury prevention or smarter management of pain. These services have proven invaluable in maintaining athletes' health, allowing them to focus on their performance, and preventing injuries.
Enhancement of Athletes' Rights
The past few years have also seen significant advancements in the rights of athletes, particularly concerning their privacy, health and safety. Lead by panels of concerned athletes, organizations such as the World Anti-Doping Agency (WADA) and the International Olympic Committee (IOC) implemented more clear regulations and now support protocols to protect athletes from mistreatment or abuse, including lack of privacy. Programs like that of the U.S. Center for SafeSport were incorporated to push these regulations and protocols into reality.
One of the key developments with athlete safeguarding was the emphasis on informed consent and transparency. Athletes have had increasing access to information about the performance enhancing substances from anti-doping authorities, but they are also seeking transparency on substances they are consuming and the potential risks. Transparency has included publication of anti-doping policies and expert panels behind the updates (this level of transparency has been on-going for decades now) and standardization / update to the approval process for therapeutic use exemptions (TUEs) around the globe. A list of individuals with whom no athlete or athlete support personnel should associate is publicly available. A growing list of individuals found to have mistreated or abused athletes is also publicly available. Stakeholders are more open to difficult conversations around athlete health and safety, and in most countries, elite athletes do have a level of protected status as a vulnerable population.
Sports Pharmacists play a vital role in educating and safeguarding athletes from mistreatment with therapies for which there is no demonstrated need, no indication or may cause short- or long-term harm.
Additionally, the importance of mental health in sports has exploded. Athletes have been more encouraged to speak out, speak up for their well-being, and also to seek support for mental health issues. Sports Pharmacists play a crucial role in providing counseling on appropriate medication selection as part of a behavioral-skills treatment plan and in identifying safer medication options when non-drug therapy is not enough. This holistic approach to athlete well-being is a significant step forward in ensuring their long-term health and success.
Increased Awareness Among Athletes
Athletes today are more informed and conscientious about their exposure to substances. This shift towards greater awareness has been driven by social media, awareness of inadvertent cases of doping, education initiatives, and the collaborative efforts of sports and exercise healthcare professionals often in partnership with national / regional antidoping authorities.
Sports Pharmacists are now racing to the forefront of this social media information campaign, offering networking, webinars, and one-on-one consultations to educate peers, other healthcare professionals, and athletes about safe medication use and the risks of dietary supplements. Qualified Sports Pharmacists emphasize the importance of adhering to medication indications based on science, using evidence-based therapeutic options that are safe for long-term health, abiding by anti-doping regulations, understanding the ingredients in supplements, and seeking professional advice before starting / stopping / changing any medication or supplement.
Digital platforms and mobile apps have made it easier for athletes to access reliable information about medications and supplements, but the amount of information may be overwhelming and the expert voice may get buried by others who are much less qualified but have a large marketing budget to flood the scene. Nonetheless, Sports Pharmacists have valuable expertise to contribute to these platforms, provide expertly crafted clinical pearls and keep up-to-date information on safe practices pumping into the social media space.
Looking Toward the Future
A period of growth and evolution in the field of sports and exercise medicine has included the contributions and opportunities for pharmacists. Through innovation, perseverance, and collaborative practice agreements, Sports Pharmacists have expanded their skills, their opportunities in new roles, and are becoming essential members of the sports medicine team. The enhancement of athletes' rights and the increase in athlete awareness underscore the importance of inviting qualified Sports Pharmacists to join the team in promoting health and safety in sports.
As we look to the future, the role of pharmacists in sports and exercise medicine will likely continue to evolve, driven by refocusing on healthcare over sickcare, advancements in technology, and changes in regulatory frameworks. By standing ready to "catch the ball" of these developments, all pharmacists can continue to make significant contributions to the health and well-being through physical activity and mental health for athletes and any patients, ensuring that they engage in sport safely and fairly to achieve their full potential.
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