Medication use and driving patterns in older drivers: preliminary findings from the LongROAD study

Linda L Hill,Samantha Pitts,Howard Andrews,David Strogatz,David W Eby,David Merle,Vanya Jones,Marian E Betz,Tara Kelley-Baker,Carolyn G Diguiseppi,Guohua Li,Patricia Pepa

doi:10.1186/s40621-020-00265-y

Abstract

BackgroundThe potential for impaired driving due to medication use can occur at any age, though older adults are more likely to take multiple prescribed medications and experience side effects that may affect driving ability. The purpose of this study was to characterize the relationship between medications and driving safety behaviors.MethodsData for this study came from the five-site Longitudinal Research on Aging Drivers (LongROAD) project. Participants were active drivers, age 65–79 years at enrollment, and patients at one of the 5 participating sites. Medication names and doses were obtained at baseline based on the “brown-bag review” method. Medications were coded using the American Hospital Formulary Service system. Driving data were collected by a GPS accelerometer installed in the study participants’ main vehicles.ResultsMedication data were available for 2949 (98.6%) of the 2990 participants, and 2898 (96.9% of all participants) had both medication data and at least 30 recorded days of driving. The median number of medications taken per study participant was seven, with a range of 0–51. Total number of medications was significantly associated with a higher rapid deceleration rate. Certain medication classes were significantly associated with other driving outcomes, including central nervous system agents (more speeding events), hormones and gastrointestinal medications (more rapid decelerations), electrolytes (fewer rapid decelerations), and antihistamines (greater right to left turn ratio).ConclusionsOlder adult drivers are taking large quantities of prescription and non-prescription medications that may affect their driving safety. Certain medication classes are associated with potentially adverse driving patterns, such as speeding and rapid decelerations, while others are associated with potentially protective maneuvers, such as right hand turning. Further research is warranted to identify and mitigate potential adverse effects of such medications on driving safety in older adults.

Highlights

The potential for impaired driving due to medication use can occur at any age, though older adults are more likely to take multiple prescribed medications and experience side effects that may affect driving ability
Prescribed medications, over the counter (OTC) medications, and recreationally used drugs, including alcohol, have the potential to interfere with the ability to drive safely (Ray et al 1993; National Highway Traffic Safety Administration 2008; National Highway Traffic Safety Administration 2010; Hetland and Carr 2014), with the risk increasing with the number of medications (MonárrezEspino et al 2014)
Participants drove an average of 253 days during the first 12 months after GPS installation; of the mean annualized number of miles driven per year was 9437 miles per year; the mean of rapid deceleration events was 5.42 per 1000 miles driven; the mean number of speeding events per 1000 miles driven was 7.83; the mean ratio of right-to-left turns was

Summary

Introduction

The potential for impaired driving due to medication use can occur at any age, though older adults are more likely to take multiple prescribed medications and experience side effects that may affect driving ability. In a meta-analysis of 27 studies, Rudisill et al found that 15 (28.3%) of the 53 medications studied were associated with an increased risk of a motor vehicle crash (MVC) (Rudisill et al 2016a). Many of these medications were benzodiazepines and narcotic pain medications, classes that are more commonly studied than other medication classes in both driving assessment and simulation studies

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