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Family Physicians’ Attitudes and Practices Regarding Assessments of Medical Fitness to Drive in Older Persons

Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Background

Higher crash rates per mile driven in older drivers have focused attention on the assessment of older drivers.

Objective

To examine the attitudes and practices of family physicians regarding fitness-to-drive issues in older persons.

Design

Survey questionnaire.

Participants

The questionnaire was sent to 1,000 randomly selected Canadian family physicians. Four hundred sixty eligible physicians returned completed questionnaires.

Measurements

Self-reported attitudes and practices towards driving assessments and the reporting of medically unsafe drivers.

Results

Over 45% of physicians are not confident in assessing driving fitness and do not consider themselves to be the most qualified professionals to do so. The majority (88.6%) feel that they would benefit from further education in this area. About 75% feel that reporting a patient as an unsafe driver places them in a conflict of interest and negatively impacts on the patient and the physician–patient relationship. Nevertheless, most (72.4%) agree that physicians should be legally responsible for reporting unsafe drivers to the licensing authorities. Physicians from provinces with mandatory versus discretionary reporting requirements are more likely to report unsafe drivers (odds ratio [OR], 2.78; 95% confidence interval [CI], 1.58 to 4.91), but less likely to perform driving assessments (OR, 0.58; 95% CI, 0.39 to 0.85). Most driving assessments take between 10 and 30 minutes, with much variability in the components included.

Conclusions

Family physicians lack confidence in performing driving assessments and note many negative consequences of reporting unsafe drivers. Education about assessing driving fitness and approaches that protect the physician–patient relationship when reporting occurs are needed.

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Acknowledgments

We would like to thank Sue Woodard for her administrative assistance and Sooyeol Lim for his assistance in the initial data analysis.

This study was partially funded by the Geriatrics Fund, University Health Network and by the Canadian Institutes of Health Research Canadian Driving Research Initiative for Vehicular Safety in the Elderly (http://www.CanDRIVE.ca). Dr. Jang was supported by a Faculty of Medicine Summer Research Scholarship (2003), University of Toronto. Dr. Naglie is supported by the Mary Trimmer Chair in Geriatric Medicine Research, University of Toronto. The Toronto Rehabilitation Institute receives funding from the Ontario Ministry of Health and Long Term Care Provincial Rehabilitation Research Program. Dr. Hogan is supported by the Brenda Strafford Foundation Chair in Geriatric Medicine, University of Calgary. An earlier version of this study was presented at the Canadian Geriatrics Society Annual General Meeting in Toronto on May 30th 2004, and at the Tri-University (University of Toronto, McMaster University, University of Western Ontario) Geriatric Resident Research Day in Toronto in June 2004.

Potential Financial Conflicts of Interest

None disclosed.

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Corresponding author

Correspondence to Gary Naglie MD.

Appendix

Appendix

Survey Questionnaire

Family Physicians’ Views on Driving Assessments in Older Persons

Are you in an active family practice that includes patients 65 years and older?

□Yes. Please complete the rest of the survey.

□No. Do not complete the rest of the survey, but please return it as well as the enclosed postcard.

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Jang, R.W., Man-Son-Hing, M., Molnar, F.J. et al. Family Physicians’ Attitudes and Practices Regarding Assessments of Medical Fitness to Drive in Older Persons. J GEN INTERN MED 22, 531–543 (2007). https://doi.org/10.1007/s11606-006-0043-x

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  • DOI: https://doi.org/10.1007/s11606-006-0043-x

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