Best Practice Guidance for Male Individuals Using Anabolic Androgenic Steroids in Recreational Sports Within Primary Care: Protocol for a Modified Delphi Consensus Study.

BACKGROUND

The nonmedical use of anabolic androgenic steroids (AASs) has become a considerable substance use concern worldwide, and it is a growing public health risk, particularly among male individuals in recreational sports. Individuals who use these substances for recreational purposes may experience various medical problems. However, there is a lack of high-quality guidance and consensus among medical experts regarding the adequate provision of medical care for this population.

OBJECTIVE

This study aims to develop best practice guidance for health care professionals providing medical care to individuals engaging in the nonmedical use of AASs by achieving consensus on relevant and feasible measures for the Swiss primary care context.

METHODS

The Delphi consensus method will be applied in this study to develop best practice guidance, following the criteria for conducting and reporting Delphi studies (DELPHISTAR). The development of evidence-based, relevant, and feasible measures for primary care practice follows a mixed methods approach to identify the problem area by conducting 4 substudies: a scoping literature review, incorporation of medical experience, peer involvement, and the selection of a heterogeneous research steering group of medical experts based on individual and group discussions. This Delphi consensus study consists of 3 rounds of anonymous web-based surveys with medical experts in primary care (N=25 Delphi panelists). Recruitment will occur through a network of primary care experts at the University of Zurich. Participants will rate each measure for relevance and feasibility using a 5-point Likert scale and provide comments and recommendations for additional measures. Each measure will require more than 75% agreement in both relevance and feasibility to achieve consensus. Descriptive statistics will be used. Aggregated ratings will be statistically analyzed for response rates, level of agreement, medians, and IQRs. Qualitative responses will be analyzed thematically and evaluated by the steering group for inclusion in subsequent rounds. The final draft of the resulting best practice guidance will be reviewed by an external board of medical associations, and approval will be sought before publication and dissemination.

RESULTS

The resulting best current clinical guidance is expected to be published in the summer of 2026. Ethics approval was received from the local ethics committee for this study.

CONCLUSIONS

With the development of high-quality best practice guidance for health care professionals in primary care, this Delphi study will help close the existing treatment gap among people using AASs. As a strength, primary care offers low-threshold access to health care, chronic care management, and coordination within the health care sector for patients experiencing multiple AAS-related health complications. The Delphi technique is an appropriate study design to develop consensus among a group of medical experts, with the strength of maintaining anonymity throughout the survey process.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/65233.