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Glucocorticoid prescribing habits of sports medicine physicians working in high-performance sport: a 30-nation survey
  1. David Hughes1,
  2. Nicole Vlahovich1,
  3. Marijke Welvaert2,3,
  4. Nicolin Tee1,
  5. Peter Harcourt4,
  6. Susan White5,
  7. Alan Vernec6,
  8. Ken Fitch7,
  9. Gordon Waddington8
  1. 1 Sports Medicine, Australian Institute of Sport, Bruce, Australian Capital Territory, Australia
  2. 2 Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
  3. 3 UCRISE, University of Canberra, Canberra, Australian Capital Territory, Australia
  4. 4 Australian Football League, Docklands, Victoria, Australia
  5. 5 OPSMC, Richmond, Victoria, Australia
  6. 6 WADA, Montreal, Québec, Canada
  7. 7 Faculty of Life Science, University of Western Australia, Crawley, Western Australia, Australia
  8. 8 Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
  1. Correspondence to Dr David Hughes, Sports Medicine, Australian Institute of Sport, Bruce, ACT 2617, Australia; david.hughes{at}ausport.gov.au

Abstract

Objectives Glucocorticoids are commonly prescribed in medicine. When administered via certain routes, glucocorticoids are prohibited for incompetition use by WADA. The glucocorticoid prescribing habits of sports medicine doctors have not been reported.

Methods An online survey was distributed internationally to physicians working in high-performance sports. The survey queried the doctors about their use of glucocorticoids with athletes and their understanding of WADA’s regulations regarding glucocorticoid use in competition.

Results 603 sports medicine doctors from 30 different countries participated. The majority (>85%) routinely injected glucocorticoids and/or prescribed glucocorticoids by other routes. There were substantial differences in the common routes of injection as well as types of glucocorticoid used among the physicians from various countries. A relatively small percentage of sports doctors (<25%) accurately identified which routes of glucocorticoid administration are prohibited in competition by WADA. There was a great variation in how long before competition the use of glucocorticoids would cause the doctor to consider applying for a therapeutic use exemption (TUE). A better understanding of the clearance rates of glucocorticoids from athletes’ bodies would greatly aid sports medicine doctors’ decisions on how and when to apply for a TUE. A small number of doctors had observed side effects of glucocorticoid administration, with the majority of side effects being minor in nature.

Conclusion Glucocorticoids are widely prescribed by sports physicians. There is a need to better educate sports physicians on the current WADA regulations in relation to glucocorticoid administration.

  • sports medicine
  • athlete
  • doping
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Footnotes

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  • Contributors DH, NV, PH, SW, AV, KF, GW were involved in study design. NV, MW, NT were involved in data analysis. All authors contributed to writing and reviewing the manuscript.

  • Funding Funding to conduct this survey was received from WADA.

  • Competing interests AV is an employee of WADA. WADA provided funding for the translation of the survey into languages other than English.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Australian Institute of Sport, Human Research Ethics Committee (approval number 20170605). All respondents provided informed consent to include their responses in the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Original survey data are available through the corresponding author.

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