Doping in sport: a review of medical practitioners' knowledge, attitudes and beliefs.

BACKGROUND: Central to the work of many medical practitioners is the provision of pharmaceutical support for patients. Patients can include athletes who are subject to anti-doping rules and regulations which prohibit the use of certain substances in and out of competition. This paper examines the evidence on medical practitioners' knowledge, attitudes and beliefs towards doping in sport. METHODS: A systematic search strategy was followed. Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches limited to English language articles published between 1990 and 2010. Articles were assessed for relevance by two independent assessors and the results of selected studies were abstracted and synthesised. Outcomes of interest were knowledge, attitudes and beliefs in relation to doping in sport. RESULTS: Six studies met the inclusion criteria and were examined in detail. Samples reflected a range of medical practitioners drawn from the UK, France (2), Greece, Italy and Ireland. The investigations varied with respect to outcome focus and quality of evidence presented. CONCLUSION: Whilst the extant empirical research posits a negative attitude towards illegal performance enhancement combined with a positive inclination towards doping prevention, it also exposes a limited knowledge of anti-doping rules and regulations. Insufficient education, leading to a lack of awareness and understanding, could render this professional group at risk of doping offences considering Article 2.8 of the World Anti-Doping Agency Code (WADC). Moreover, in light of the incongruence between professional medical codes and WADC Article 2.8, medical professionals may face doping dilemmas and therefore further discourse is required. At present, the current evidence-base makes it difficult to plan developmentally appropriate education to span the exposure spectrum. Addressing this situation appears warranted.