A simulated-patient study of community pharmacies in Croatia found that only 10% gave fully accurate, World Anti-Doping Agency-consistent advice when asked about a common asthma medication's use in competition. The research, published in the Harm Reduction Journal, highlights a practical gap between anti-doping policy and the advice athletes may actually receive over the phone.
How the study was conducted
In July 2024, a trained professional athlete telephoned 99 randomly selected community pharmacies across Croatia, asking whether continued use of inhaled salbutamol was permissible under international competition rules. Valid, complete interactions were recorded with 80 of those pharmacies. Researchers then assessed each response against World Anti-Doping Code standards for accuracy and completeness, and used statistical tests-including chi-square/Fisher's exact tests and binary logistic regression-to identify patterns associated with better or worse advice.
What the responses revealed
Most pharmacists did not ask the kinds of clinical questions needed to give tailored advice: 70% failed to elicit relevant patient information before responding. More than half, 57.5%, simply referred the caller elsewhere, most often to a physician (37.0%). The analysis found that referral was linked to lower odds of adequate advice (odds ratio 0.2, p = 0.046), while pharmacists who asked patient-related questions showed a borderline association with better advice (odds ratio 4.9, p = 0.051). The authors caution that these are exploratory findings from a single simulated scenario, reflecting tendencies rather than proven cause-and-effect relationships.
Why it matters for athletes and pharmacy practice
Under the World Anti-Doping Code, pharmacists are formally designated Athlete Support Personnel, a role that positions them as a frontline resource for preventing unintentional doping violations. Yet the study suggests many pharmacists are not yet equipped to fill that role consistently, whether due to training gaps, unfamiliarity with anti-doping rules, or reliance on referral rather than direct clinical guidance. The authors argue that embedding anti-doping knowledge more systematically into pharmacy education and routine practice could help close this gap and better protect athletes from inadvertent rule violations.
Limits of the findings
The study was limited to one country, one medication scenario, and a single simulated-patient design, so its findings should not be generalized to all pharmacies or medications without further research. It was published as an open-access, peer-reviewed accepted manuscript on October 17, 2026, carrying a permanent DOI, and remains subject to minor edits before a final Version of Record is issued.