TY - JOUR
T1 - Potentially Driver-Impairing (PDI) Medication Use in Medically Impaired Adults Referred for Driving Evaluation
AU - Hetland, Amanda J.
AU - Carr, David B.
AU - Wallendorf, Michael J.
AU - Barco, Peggy P.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Amanda J. Hetland, NIH and NCATS; David B. Carr, MD, NIH, Pfizer, and MoDOT Division of Highway Safety; Peggy P. Barco, MS, BSW, OT/L, NIH and MoDOT Division of Highway Safety. This publication was made possible by Grant Number UL1 TR000448 and TL1 TR000449 from the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health. This work was also supported in part by the Missouri Department of Transportation Division of Highway Safety, the LongerLife Foundation, the Washington University Alzheimer’s Disease Research Center (P50AG05681, Morris PI) and the program project Healthy Aging and Senile Dementia (P01AG03991, Morris PI) from the National Institute on Aging. Additional support was provided by the National Institutes of Health through Grant Number RO1 AG043434-01, Roe PI. We disclose no relevant conflicts of interest.
PY - 2014/4
Y1 - 2014/4
N2 - Background: Potentially driver-impairing (PDI) medications have been associated with poorer driving performance and increased risk of motor vehicle collision. Objectives: To describe the frequency of medication use and to determine the association between routine use of PDI medications and performance on driving and cognitive tests. Methods: A total of 225 drivers with medical impairment (mean age 68 ± 12.8 years, 62.2% male) were referred to an occupational therapy-based driving evaluation clinic. Medication lists were reviewed to identify PDI drugs, as defined by a previous study examining medications and crash risk. Outcome variables included road testing on the modified Washington University Road Test and cognitive scores on Trail Making Test Parts A and B, Snellgrove Maze Task, Clock Drawing Task, Driving Health Inventory (DHI) Useful Field of View, DHI Motor Free Visual Perceptual Test, Epworth Sleepiness Scale (ESS), Geriatric Depression Scale, and Functional Assessment Questionnaire. Results: PDI medication use was documented in 68.9% of the sample, with the average subject taking 1.4 PDI drugs. Drivers taking routine PDI medications had a mean ESS score of 7.8 compared to 6.0 in the control group, suggesting increased somnolence (P =.007). Total number of routine medications, regardless of PDI designation, also correlated positively with ESS scores (P =.023). Conclusions: Use of PDI medications was associated with informant ratings of daytime drowsiness on the ESS, which has been linked to motor vehicle crash risk. Further investigation of individual drug classes is warranted using larger sample sizes and a high-powered study design.
AB - Background: Potentially driver-impairing (PDI) medications have been associated with poorer driving performance and increased risk of motor vehicle collision. Objectives: To describe the frequency of medication use and to determine the association between routine use of PDI medications and performance on driving and cognitive tests. Methods: A total of 225 drivers with medical impairment (mean age 68 ± 12.8 years, 62.2% male) were referred to an occupational therapy-based driving evaluation clinic. Medication lists were reviewed to identify PDI drugs, as defined by a previous study examining medications and crash risk. Outcome variables included road testing on the modified Washington University Road Test and cognitive scores on Trail Making Test Parts A and B, Snellgrove Maze Task, Clock Drawing Task, Driving Health Inventory (DHI) Useful Field of View, DHI Motor Free Visual Perceptual Test, Epworth Sleepiness Scale (ESS), Geriatric Depression Scale, and Functional Assessment Questionnaire. Results: PDI medication use was documented in 68.9% of the sample, with the average subject taking 1.4 PDI drugs. Drivers taking routine PDI medications had a mean ESS score of 7.8 compared to 6.0 in the control group, suggesting increased somnolence (P =.007). Total number of routine medications, regardless of PDI designation, also correlated positively with ESS scores (P =.023). Conclusions: Use of PDI medications was associated with informant ratings of daytime drowsiness on the ESS, which has been linked to motor vehicle crash risk. Further investigation of individual drug classes is warranted using larger sample sizes and a high-powered study design.
KW - driving safety
KW - drugs and driving
KW - medically impaired drivers
KW - older adult drivers
KW - potentially driver-impairing medications
UR - https://www.scopus.com/pages/publications/84898688502
U2 - 10.1177/1060028014520881
DO - 10.1177/1060028014520881
M3 - Article
C2 - 24473491
AN - SCOPUS:84898688502
SN - 1060-0280
VL - 48
SP - 476
EP - 482
JO - Annals of Pharmacotherapy
JF - Annals of Pharmacotherapy
IS - 4
ER -