Mark Stuart
Published in the Pharmaceutical Journal, UK, 2002
With only days until the XVII Commonwealth Games, the largest sporting event ever to be held in the UK, and highlight of the Queen’s Jubilee celebrations, excitement is mounting as organisers are nearing the conclusion of many years of preparation. Around 5000 athletes from 72 countries will converge on Manchester to compete from the 25th of July to the 4th of August. Mark Stuart, superintendent pharmacist of the Athletes’ Village Medical Centre Pharmacy, gives an insight into the pharmacy preparations.
Over the last year and a half, a dedicated pharmacy-working group consisting of pharmacist representatives from NHS trusts in the Greater Manchester area, as well as a number of pharmacists involved in sports medicine, has been meeting monthly. The pharmacy-working group has constructed policies, procedures, and developed the services that the pharmacy will provide. They have anticipated the many unique issues that an event of this type will present.
The pharmacy will be part of a purpose built polyclinic in the heart of the Commonwealth Games Village. The University of Manchester Fallowfield campus student accommodation will be transformed into the Village, a buzzing metropolis of international athletes during the time of the Games.
This is no ordinary pharmacy. The patients in the Village will include elite athletes of many nationalities and cultures. It will act as the distribution point for drugs needed by doctors at 15 venues around Manchester including the new 38,000 seat capacity City of Manchester Stadium and will vigilantly monitor athlete’s medication according to international anti-doping laws. A custom designed dispensing program will alert the pharmacist at the time of dispensing, to the status of a drug in relation to sporting law. All medication, including OTC drugs, will be dispensed only on prescription, further reducing the risk of athletes taking a prohibited substance.
The pharmacy team will ensure that athlete drug treatment complies with the Olympic Movement Anti-Doping Code. This is the internationally recognised list of substances that are prohibited or have restrictions when used by competing athletes. The list of prohibited substances includes the classes- stimulants, narcotics, anabolic agents, diuretics and peptide hormones. Substances prohibited in certain circumstances include alcohol, cannabinoids, local anaesthetics, glucocorticosteroids, and beta-blockers.
Pharmacists will also be monitoring the way drugs are administered to comply with this code. For example glucocorticosteroids are permitted only when used locally or intra-articularly when medically necessary. Use of formulations which result in systemic absorption, such as oral, rectal, or intravenous or intramuscular injections are prohibited. Likewise, only local or intra-articular injections of local anaesthetics can be administered when medically justified.
The pharmacy-working group has produced a formulary specifically for the Games, which reflects the requirements of sports medicine and necessary medical care for athletes, officials and staff. A wide range of anti-inflammatory drugs have been included and are expected to be frequently prescribed, as has proven to be the case at previous games. There will be a dense population of people living in the village, thus having a broad spectrum of anti-infective medicines on the formulary has been important, given the potential infection control issues that this situation may present.
The formulary lists the status of each drug according to the Olympic Movement Anti-Doping Code and requirements for notification prior to competition should it be necessary. For example an athlete can use salbutamol, which falls into the stimulant category, only if they have proven asthma or exercise induced asthma. Written notification by the team doctor is necessary before the athlete competes. Similarly for insulin, which is permitted only to treat athletes with insulin-dependent diabetes. The formulary contains information on prohibited substances necessary to promote a fair sporting environment.
The whole spectrum of medical services will unite to provide the highest standard of healthcare to the ‘Games Family members’ which are athletes, team officials, and support crew. Those volunteering their services include sports doctors, dentists, podiatrists, pharmacists, physiotherapists, optometrists, and nurses.
A team of 16 enthusiastic volunteer pharmacists from all over the UK has been selected to run the pharmacy from the time the Village opens on the 15th of July, till the close of the Village on the 7th of August. An interest in sports medicine, and availability for the Games period was part of the selection criteria. They will be provided with an official Games uniform including a flat cap, to be worn backwards in keeping with the spirit of the Manchester area. They will also receive free meals and transport while they are working.
Volunteer pharmacists have had the opportunity to attend a number of training days, to prepare them for this special event. Training has covered issues specific to working in a games environment. Topics included- prohibited substances in sport, doping control, dealing with the media, confidentiality, security in the Athletes’ Village, radio communication, and professional interaction with the athletes. Volunteers recently attended a pharmacy specific training day after the Village was completed, where they could familiarise themselves with the new Village Medical Centre and inspect the facilities prior to opening day.
A drugs-in-sport information pack has been sent to pharmacies in close proximity to the Village, NHS emergency departments, and pharmacies at Manchester Airport, who are most likely to come into contact with athletes requiring medication around the time of the Games. The pack contains information on what athletes can and can’t take according to the Olympic Movement Anti-Doping Code. It is hoped the packs will prevent athletes from inadvertently taking prohibited substances, particularly those found in OTC preparations.
A number of drug companies have shown their support for the Games. Bayer, Castlemead, Crookes Healthcare, Schering Plough and Shire Pharmaceuticals, have generously donated some supplies for dispensing from the Village Medical Centre Pharmacy. The National Pharmaceutical Association is subsidising indemnity cover for the volunteer pharmacists and The Royal Pharmaceutical Society has lent essential reference books for the Games period.
This is an exciting opportunity for pharmacists to be involved in an international sporting event and be part of a medical team, caring for elite athletes from around the world. The pharmacy team will deliver a unique service to athletes and will help to maintain a fair sporting environment. This year’s XVII Commonwealth Games is set to be the biggest and best yet.