Has adequate consideration been given to permitted alternatives?
If it is determined that the patient-athlete has a medical condition that requires treatment with a prohibited substance/method, the next step would be to assess if there are any permitted alternatives to the prohibited substance/method. If there are, then the treating medical provider should identify those options and make a medically-informed decision in consultation with the patient-athlete as to the best treatment regimen, taking into consideration the patient-athlete’s competition status.
All clinical decisions for the use of prohibited substance/method should be clearly annotated in a clinical note that includes the medical history, evaluation, review of symptoms, assessment, diagnosis and treatment plan. Objective medical data to support the decision if a prohibited substance must be used, is highly recommended, as well as a reference number from search results of GlobalDRO.