Abstract 3463: Physicians’ Knowledge of Driving Limitation Following Stroke or TIA is Inadequate

Abstract

Background: An increasing number of TIA and minor stroke patients are assessed and discharged by front-line staff in emergency or acute assessment units. As capacity to drive is affected by a stroke or TIA, we assessed the level of knowledge of driving restrictions after stroke or TIA in frontline doctors. Method: A structured multiple choice questionnaire was used to assess knowledge of driving restrictions after stroke in 195 doctors involved in assessing patients in the Emergency Department or acute assessment units. The questionnaire took between 10-15 minutes to complete and tested knowledge of driving restrictions after minor stroke or TIA for those holding a domestic (Group 1) or a commercial (Group 2) licence. The wording of the questions was similar to that used in statutory medical guidance by the Licensing Authority. Results: The 195 doctors included 8 consultants, 88 senior residents, 22 junior residents and 77 foundation level trainees. Only 43 (23%) doctors had been specifically instructed about driving restrictions in stroke; 89 (45%) had received no formal education on driving restrictions following medical illnesses. The majority (155, 86%) were aware that it was patients’ responsibility to inform the licensing agency of driving restrictions due to medical illnesses. Only 72 (37%) and 84 (43%) doctors correctly identified that TIA patients were not allowed to drive for 1 month if holding a domestic licence and for 1 year if holding a commercial licence respectively. Forty eight (25%) believed that no restrictions applied after a TIA. Driving restrictions for stroke with complete recovery of 1 month for domestic and 1 year for commercial license were correctly answered by 56 (29%) and 117 (71%); only 23 (12%) thought that no restrictions applied. There were no significant variations in knowledge attributable to seniority, formal instruction of driving regulations or working with stroke patients. Conclusions: Doctors have limited knowledge of driving restrictions after TIA or minor stroke, which presents significant public safety and medico-legal risks. Innovative methods are required to improve the acquisition and retention this knowledge in front line doctors.