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HEALTH NUTRITION
BANNED SUBSTANCES
Sports Nutritionist and Accredited Practising Dietitian Christie Johnson points to the plentiful resources available around banned substances in sport.
“Most or all sports dietitians have experience in looking at WADA and ASADA, and there’s a lot of great resources out there now, explaining banned substances and what’s on the list and what isn’t.,” she said.
“There’s [also] a lot of great apps these days to check products that may not list ingredients all the time.”
For more information, visit: • WADA: wada-ama.org
• ASADA: asada.gov.au
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to communicate the basics of nutrition to customers and to then refer on to a dietitian when required.
“Not everyone’s going to need or benefit from a dietitian, and there’s
a really nice scope of practice within that, that [pharmacists] can provide basics of nutrition: ... increased plant foods, variety, quality of foods, and then referring on when it does come into the play of disease states where there are complexities,” she said.
“That’s where that referral process
is very, very valuable. Where [a pharmacist] can give the basics but then, onward, when there’s that specific condition ... that’s when the dietitian can really step in and support what [the pharmacist is] saying and support with more tangible outcomes.
“It’s important that a pharmacist has a really good basic knowledge between food and diabetes, or whatever the disease might be that someone is coming in with. However, it may be that the translation from the science to the nutrition, or how that person actually eats, just isn’t there, or is unable to be translated in a way that’s applicable
to the individual. And that’s where the dietitian comes in.”
Enhancing confidence through professional development
One reason pharmacists may not give nutrition advice to customers is said to be a lack of confidence. The solution may be linking with various professional associations, such as the DAA, and local dietitians, for professional development opportunities.
“I think there’s a few different approaches that can be taken from a local point of view ... working together and having nutrition talks, whether it
be with all the pharmacists or in the community and having [customers] come in for a collaborative chat [is one way to do it],” Ms Johnson said.
Ms Edge added: “Between ... dietitians and pharmacists, there’s a lot of commonality that can be shared both
in that [customer] reach, but also in the knowledge base as well.
“Just as much, pharmacists may be able to get professional development ... from a dietitian. Dietitians can learn a lot from pharmacists, as well. I do believe
a reciprocal relationship would be a valuable one.”
Beware of complex situations
While it’s within a pharmacist’s professional scope to give basic healthy-eating advice, there are instances a pharmacist should be aware of that certainly require dietetic input. An example of this is within the
sporting context.
“The interesting thing with this,” Ms Edge
said, “is that we’ve had this issue in the past where pharmacists, naturopaths [and] supplement stores have actually given athletes, without meaning to, supplements that are on the banned list.”
Ms Edge adds that pharmacists aren’t expected to know everything when it comes to specific situations and complexities, and in these cases “there are experts that do have that knowledge” whom pharmacists can refer customers to.
“Obviously, pharmacists have an important job in terms of that relationship between different supplements and medications, and I think that’s truly valuable,” she said.
“And then dietitians can branch off that in terms of the actual application of [the supplement], [its] relevance and the place that nutrition might have, instead of [the supplement].”
According to Ms Edge, regarding treatment for athletes, dietitians (or sports dietitians in this case) are trained to know the “important things that need to be asked in terms of not only the medications an athlete is taking, but also in terms of the supplements they’re taking as well”.
Ms Johnson adds that when dealing with athletes who may walk into a
pharmacy, pharmacists “need to be aware of banned substances as well, and what ... products may contain traces of them even if they don’t contain them as an active ingredient”.
“Keeping on top of WADA [World Anti- Doping Agency] or ASADA [Australian Sports Anti-doping Authority] or at least explaining [the risks] to athletes that come in [is important],” Ms Johnson said, “and when possible, suggesting products that have been batch tested or third party tested, because that will reduce the chances of getting tested positive.”
While keeping abreast of all the latest information comes with the territory
in being a pharmacist, Ms Edge said: “As soon as you’re feeling that you’re going beyond healthy eating [advice], there should be a referral pathway available, or at least a recommendation made to the customer to reach out to
a dietitian.”
A proactive, two-way street
“I absolutely refer people to [dietitians] in complete confidence that they’ll be given the best advice possible without any fear of backlash,” Mr Quigley
said, explaining the importance of interprofessional referral.
“[Any nutrition advice] I suggest is always given with the proviso that they should always run [it] past [the professional who] is much more appropriately qualified.”
While there may be some differences in professional opinion between pharmacists and dietitians, Mr Quigley says he doesn’t mind this and suggests others should follow suit.
“They [dietitians] are the experts,”
he said. “I’d expect a dietitian who
has a query on a medication to confidently refer that person back to me and I’d be able to give that person, and the dietitian, the reassurance
that they were being given the best information possible.”
According to Mr Quigley, forming networks and partnerships isn’t
as challenging as some may
think. To him, it’s simply a case of being proactive about forming the interprofessional relationships.
His advice to pharmacists? “You drive to a practice and you walk in and say, ‘Can
I see someone?’ – that doesn’t happen often enough these days,” he said.
“And just tell the person: ‘I’m part of the team. If there’s anything from a
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RETAIL PHARMACY ASSISTANTS • MAR 2020