PTU-083 Advice given to patients with alcohol excess regarding fitness to drive

Background: On-road driving behavior can be impaired in older drivers and particularly in drivers with mild cognitive impairment (MCI). Objective: To determine whether cognitive and non-cognitive risk factors for driving safety may allow an accurate and economic prediction of on-road driving skills, fitness to drive, and prospective accident risk in healthy older drivers and drivers with MCI, we examined a representative combined sample of older drivers with and without MCI (N = 74) in an observational on-road study. In particular, we examined whether non-cognitive risk factors improve predictive accuracy provided by cognitive factors alone. Methods: Multiple and logistic hierarchical regression analyses were utilized to predict different driving outcomes. In all regression models, we included cognitive predictors alone in a first step and added non-cognitive predictors in a second step. Results: Results revealed that the combination of cognitive and non-cognitive risk factors significantly predicted driving skills (R2adjusted = 0.30) and fitness to drive (81.2% accuracy) as well as the number (R2adjusted = 0.21) and occurrence (88.3% accuracy) of prospective minor at-fault accidents within the next 12 months. In all analyses, the inclusion of non-cognitive risk factors led to a significant increase of explained variance in the different outcome variables. Conclusion: Our findings suggest that a combination of the most robust cognitive and non-cognitive risk factors may allow an economic and accurate prediction of on-road driving performance and prospective accident risk in healthy older drivers and drivers with MCI. Therefore, non-cognitive risk factors appear to play an important role.

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Recruitment of Older Drivers from Primary Care Clinics for on-Road Fitness-to-Drive Testing: Results of a Pilot Study

Journal of the American Geriatrics Society ◽

10.1111/jgs.12913 ◽

2014 ◽

Vol 62 (7) ◽

pp. 1388-1390

Author(s):

Marian E. Betz ◽

David B. Carr ◽

Carolyn DiGuiseppi ◽

Jason S. Haukoos ◽

Steven R. Lowenstein ◽

...

Keyword(s):

Primary Care ◽

Pilot Study ◽

Older Drivers ◽

Fitness To Drive ◽

Primary Care Clinics

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Psychiatric illness, medication and driving: an audit of documentation

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2015.31 ◽

2015 ◽

Vol 33 (3) ◽

pp. 171-174 ◽

Cited By ~ 1

Author(s):

A. Gallagher ◽

S. Shah ◽

W. Abassi ◽

E. Walsh

Keyword(s):

Road Safety ◽

Psychiatric Patients ◽

Fitness To Drive ◽

Team Members ◽

The Road ◽

Significant Difference ◽

New Guidelines ◽

A Minor ◽

Inpatient Psychiatric Unit ◽

Minor Improvement

ObjectivesGuidelines on advising patients on fitness to drive have been published recently by the Road Safety Authority in collaboration with the Royal College of Physicians of Ireland. The aim of this audit is to assess if the new guidelines are being adhered to.MethodExamination of the documentation and adherence to the guidelines in the inpatient psychiatric unit, Mayo General Hospital.ResultsOf the 100 patients included in audit cycle one, none had any specific documentation about driving. One patient was admitted with alcohol misuse and was driving. On re-auditing, following presentation at academic meeting and education of team members on the guidelines, there was a minor improvement of 7%.ConclusionThere was no significant difference in documentation on re-audit. However, an increase of 7% is nonetheless encouraging. Information concerning driving should be a standard part of advice given to all psychiatric patients.

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Assessing fitness to drive after stroke

Irish Journal of Occupational Therapy ◽

10.1108/ijot-03-2018-0006 ◽

2018 ◽

Vol 46 (2) ◽

pp. 106-129

Author(s):

Aisling Helen Stack ◽

Orla Duggan ◽

Tadhg Stapleton

Keyword(s):

Occupational Therapy ◽

Clinical Guidelines ◽

Best Practice ◽

Online Survey ◽

Occupational Therapists ◽

Fitness To Drive ◽

Therapy Evaluation ◽

Content Type ◽

Evaluation Practices ◽

Education Training

Purpose The assessment of fitness to drive after stroke is an emerging area of occupational therapy practice in Ireland. Despite this, little is known about occupational therapists’ evaluation practices, and there are no internationally agreed clinical guidelines to inform best practice. The purpose of this paper is to investigate occupational therapy evaluation practices for fitness to drive after stroke in Ireland. Design/methodology/approach This is a cross-sectional study design targeting occupational therapists working with people after stroke using an online survey. Summary and descriptive statistics were used to analyse the returned surveys. Findings In total, 47 occupational therapists participated. Off-road driving assessment was completed by 68 per cent of respondents. Functional assessment and non-driving-specific assessments were most widely used and perceived to be the most useful in informing the off-road assessment. A total of 89 per cent referred clients for on-road assessments; however, some referred without first completing an off-road assessment. The therapists who completed formal post graduate education/training in driving assessment reported greater confidence and competence in their skills and ability to assess fitness to drive. A vast majority of participants agreed that clinical guidelines regarding best practice in this area would be beneficial. Research limitations/implications A majority of occupational therapists are assessing fitness to drive after stroke in Ireland with non-driving-specific assessments and functional observations; however, there are many gaps and wide variations between services. Education/training in evaluating fitness to drive after stroke is recommended. The development of clinical guidelines to inform practice would facilitate a consistent approach nationally. Originality/value This is the first study completed in Ireland to investigate occupational therapy evaluation practices for fitness to drive after stroke.

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