Challenges of assessment of drivers with cognitive impairment highlighted at publication of 2018 Medical Fitness to Drive Guidelines today

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 Gudielines 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.”

2018 Sláinte agus Tiomáint Medical Fitness to Drive Guidelines