Perceptions of health care professionals of the medical aspects of driving safety: An electronic survey

Abstract

Background: Driving a motor vehicle is a highly coordinated process involving a series of learned reflexes and carefully made conscious decisions. The evaluation of an individual's ability to drive is a legal and safety necessity. Various factors such as age and illnesses can affect individual's ability to drive. Objectives: The aims of the current survey were to ascertain the level of awareness among medical professionals of fitness to drive and to evaluate their perception of some select medical aspects of fitness to drive and regulatory aspects of driving. Materials and Methods: This is a survey of 520 health care professionals addressing select clinical and regulatory issues regarding medical aspects of driving. A de novo questionnaire of four domains was developed based on the study objectives. The target population was identified from pooled lists of health care contacts. A widely used web-based commercial survey management service was utilized. Results: Out of the 520 respondents, males and females constituted 63.5% and 36.5% respectively. Country of residence of respondents include: UAE (55.2%), other Arabian Gulf countries (13.3%), rest of MENA region (14.8%), Western Europe and North America (12.3%) and other regions (1.9%). 47.4% of the respondents were hospital doctors while 16.4% were primary care physicians. 57.3% of the respondents thought the age threshold which requires medical assessment ranged between 60-70 years. There was a wide range of intervals of reissuing licenses (1-5 years) in countries where restrictions apply above a certain age. 92.5% identified a list of conditions as declarable to authorities. More than half of respondents considered the following conditions as relevant and declarable to the authorities in a descending order of frequency: epilepsy, visual impairment, alcoholism and drug dependency, blackouts and syncope, dementia, stroke with hemiplegia and insulin-treated Diabetes. The principal safety concerns for driving with diabetes were addressed by 94.6% of respondents. 79.3% identified hypoglycemia and 18.1% identified visual impairment (diabetic retinopathy) as major barriers to safe driving. 85.1% of respondents thought that the driving risks to be higher in insulin-treated (85.1%) than in sulphonylurea-treated (9.6%) diabetic patients. The majority of respondents believe that doctors have an obligation to alert their patients about diseases that risk their driving abilities and drivers have an obligation to provide all required details to their insurance companies. Confidentiality issues were addressed in the questionnaire and 316 (68.4%) thought that both physicians and diabetic patients need to report relevant information to regulatory driving authorities and insurance companies. Conclusion: This survey indicates that there is a considerable awareness among health care professionals regarding medical conditions that may affect an individual's ability to drive. Furthermore, it seems that confidentiality issues were not considered a major barrier by health professionals when driving becomes a major threat to patients and public.