Attitude of Swiss general practitioners to mandatory training in assessing fitness to drive of older drivers.

Abstract

In Switzerland, drivers over the age of 75 must undergo a medical assessment of their fitness to drive every 2 years. This assessment is usually carried out by a general practitioner (GP). Since 2016, physicians require official accreditation (so-called level 1 competence) to perform these examinations. This can be obtained either by self-declaration of competence or by attending an accredited training course. Little is known about the Swiss GPs' views on this regulation. In this study, we investigated the attitude of GPs towards these modalities. A questionnaire was mailed to 2372 GPs in a large part of German-speaking Switzerland, 1198 of whom completed and returned the questionnaire. The anonymised data were analysed by descriptive statistics (frequencies, percentages) to summarise participant demographics and agreement with attitudinal statements. The response rate was 50.5%. Sociodemographic data (age, gender, settlement area) of the participating GPs corresponded to those of the Swiss medical statistics. The majority (93.1%) of respondents worked in an outpatient setting, 6.9% in the inpatient sector. Overall, 34.4% of the GPs completed a training course and 47.7% submitted a self-declaration in order to acquire level 1 competence. Older and more experienced physicians had made more use of the self-declaration option. 58.1% of the respondents would like to retain the existing regulations. Of the respondents who had attended a training course, 51.7% considered themselves more competent in the assessment of older drivers after the training, and 76.1% would like to maintain the course duration of 1 day. Of the physicians surveyed, 70.8% were of the opinion that level 1 examinations are a useful screening tool for older drivers who are unfit to drive, and 78.4% agreed that MFTD (medical fitness to drive) examinations of older drivers should be performed by GPs. In Switzerland, the currently existing regulation for acquiring level 1 competence is widely accepted by GPs. Almost all respondents considered that they have sufficient knowledge to assess MFTD. However, the majority of GPs who had attended the training course indicated they have benefited from it. Periodic assessment of MFTD of older drivers was considered useful and should preferably be performed by GPs. These results show that the periodic assessment of older drivers' MFTD practised in Switzerland is well accepted.