2018 News

23 October 2018

University College Cork research team publish report on the challenges of assessment of drivers with cognitive impairment in general practice

The research, presented today at the publication of the 2018 Medical Fitness to Drive Guidelines for Group 1 & 2 Drivers, by the Road Safety Authority and National Office for Traffic Medicine, highlights the difficulties of transitioning to driving retirement for patients, and the difficulties and discomfort experienced by GPs who must deal with this issue.

Speaking today at the publication of the 2018 guidelines, Professor Colin Bradley, co-author of the report spoke of the complexity of assessing drivers with cognitive impairment,

“Our research, published by PLOS One, has highlighted the need for further supports for doctors and healthcare professionals who work with patients with cognitive impairment. Many challenges exist in this area that need to be addressed. While doctors were prepared to discuss fitness to drive in people with cognitive impairment, they were more uneasy with the ‘emotionally charged task’ of determining fitness to drive. Doctors described themselves as ‘reluctant regulators.’ 

“There is a lack of clarity with the precise legal responsibilities and local resources available to GPs.  Doctors reported concern that their relationship with their patient may become compromised if they suggest driving cessation and they were aware that it could have a negative effect on patients’ quality of life.”

“Early discussions of driving capacity in people with cognitive impairment should occur and their existing doctor-patient relationship should be harnessed to assist patients and carers plan for eventual driving cessation.  Promotion of early and open conversation about fitness to drive by healthcare professionals, patient advocacy groups and the lay media should also enable earlier, better, and less fraught discussions about driving between patients and their doctors.”

Prof Desmond O’Neill, National Programme Director for Traffic Medicine at RCPI welcomed the research,

“Our ageing population means that we are seeing more people with cognitive impairment. We need to find effective ways of managing this in a way that considers the implications for our patients of driving cessation and ensuring safety on our roads for them and others, as a priority.”

“Driving safely with medical conditions places an obligation on drivers, health professionals and the National Driver Licence Service. We are delighted to launch the updated Medical Fitness to Drive Guidelines for Group 1 & 2 Drivers today.”

“These 2018 guidelines are notable as they include the new EU Directive on Cardiovascular Disease and Driving as well as new guidance on driving after transient ischaemic attack (TIA). The 2018 guidelines also incorporate rigorous review of international research and also external review which strengthens the support for Irish doctors when using the guidelines.”

Mr Declan Naughton, Director Driver Testing and Licensing said,

“With an ageing population and advances in technology and medicine driver fitness is playing an ever increasing role in ensuring safety on our roads. The update of 2018 guidelines here today underlines the commitment of the Road Safety Authority to support GPs in the area of driver fitness. The RSA acknowledges the work of GPs in applying the guidelines on the ground.”

You can download the 2018 Medical Fitness to Drive Guidelines; Sláinte agus Tiomáint here

View the full paper Consultations on driving in people with cognitive impairment in primary care: A Scoping Review of the Evidence

Notes

Sláinte agus Tiomáint provides guidance on medical fitness for drivers and highlights the need for all of us to appreciate that the state of our health impacts, to a greater or lesser degree, on our ability to drive safely. Driver fitness is governed by EU law and regulations made in Ireland under the Road Traffic Acts. Sláinte agus Tiomáint is an interpretation of these laws; however, the Directive/regulations form the overriding legal basis for driver medical fitness in Ireland. One of the objectives of Sláinte agus Tiomáint is to promote mobility and to do this in a way that is consistent with safety on our roads. Once a driver is aware of any health aspects that impact on driving and follows the advice of their doctor, they can continue to drive in most cases.

Traffic Medicine
The National Office for Traffic Medicine was established in 2011 as a joint initiative by the Road Safety Authority (RSA) and the Royal College of Physicians of Ireland to manage the development of Medical Fitness to Drive Guidelines and the development of traffic medicine policy in Ireland. The programme work is under the directorship of Professor Desmond O’Neill (NPOTM) together with the RCPI Working Group on Traffic Medicine consisting of 36 healthcare and other professional organisations.

Research team
This research was funded by the first research grant in Traffic Medicine and was led by UCC Department of General Practice.

Co-leads Research Fellow Dr Carol Sinnott and Professor of General Practice and Head of Department Prof Colin Bradley, both in the Department of General Practice at UCC, will head a team of five researchers, representing UCC (Dr Tony Foley and Linda Horgan, Departments of General Practice and Occupational Therapy, respectively), the ICGP (Dr Claire Collins, Research Director) and the Alzheimer Society of Ireland (Dr Emer Begley).

Individuals and Groups involved in the Medical Fitness to Drive process

Medical Doctors

  • Occupational Therapists
  • On-road Driving Assessors
  • Road users and the general public will also find these guidelines helpful
  • Other Healthcare Professionals

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