Dizziness and Driving From a Patient Perspective

Abstract

Background: People with dizziness may experience driving-related limitations. Few data are available about the impact of dizziness on driving.Aim: The aim of this study is to investigate the impact of dizziness on driving, factors related to impairment (age, gender, and type of diagnosis), and the potential consequences for patients' ability to work. We also investigated whether the patients expected and actually received information about their dizziness-related fitness to drive from their physician.Methods: A cross-sectional, observational study was conducted in the Apeldoorn Dizziness Centre, a tertiary care referral centre for patients with dizziness. A consecutive cohort of patients was asked to complete a study-specific questionnaire about driving.Results: Between January 1, 2020, and December 20, 2020, 432 patients were included. Fifty-six percent of the patients in this group were female. The average age of patients was 58.3 years (SD 16). Overall, 191 of the 432 patients (44%) experienced limitations related to driving, and 40% of the patients who experienced limitations also experienced limitations to work related to their inability to drive. The subject of fitness to drive had not been discussed with their physician in 92% of the patients, and 24% of the whole patient group indicated that they would have liked to discuss this topic. The following factors, independently from each other, increased the chance of experiencing driving-related limitations: younger age, female sex, and the diagnosis of Meniere's disease.Conclusion: Dizzy patients, especially younger patients, women, and patients with Meniere's disease, regularly experience limitations related to driving, and this often means that they are unable to work. Driving is hardly ever discussed during a medical consultation. In our opinion, the topic of driving and dizziness should always be addressed during medical consultations in dizzy patients.

Medical record prompts improve the frequency and documentation of dizziness and driving conversations in the ENT balance clinic

“…This means people are often unable to work, [12][13][14][15] and it has a significant impact on their lifestyle. [16][17][18][19] It is surprising that there is a reported lack of knowledge at patient and practitioner level. 17,18 Consequently, driving was not considered in 92 per cent of patients attending a centre for dizziness and balance disorders.…”

“…17,18 Consequently, driving was not considered in 92 per cent of patients attending a centre for dizziness and balance disorders. 19 However, given its importance, the topic of driving and dizziness or vertigo should always be addressed in those presenting with these symptoms, 20 and in patients taking medication that causes dizziness or drowsiness, 20 as data are consistent regarding the effects of medications used for dizziness and vertigo on driving ability. [6][7][8][9][10][21][22][23] Vestibular disorders have been shown to negatively affect driving ability in most studies, with a low risk of bias, 16,17,22 and any associated anxiety or mood disordersprevalent in vestibular disordersmay also affect driving.…”

“…These individuals report significant degrees of controllability and predictability; for example, dizziness only comes on when getting in or out of a lying-flat position, which is not related to driving a car. 1,12,13,15,19 However, one study did suggest that almost as many people with BPPV had problems that limited driving as those who did not, 22 emphasising the importance of communication during consultations. This is a neglected area of assessment.…”

“…1,25,26 It has been highlighted that drivers with vestibular conditions modify their driving habits to compensate. 13,14,19,22 A survey of otolaryngologists 25 indicated that 64 per cent believed that patients stopped driving when warned it was dangerous, and patients were more likely to be advised to stop if dizziness was constant and/or severe. , Conversely, patients did not always take the advice, with 52 per cent reporting they would continue to drive but more safely, 4 per cent would continue as usual, and only 11 per cent would not drive and consequently became more aware leading to fewer accidents.…”

“…17,18 Consequently, driving was not considered in 92 per cent of patients attending a centre for dizziness and balance disorders. 19 However, given its importance, the topic of driving and dizziness or vertigo should always be addressed in those presenting with these symptoms, 20 and in patients taking medication that causes dizziness or drowsiness, 20 as data are consistent regarding the effects of medications used for dizziness and vertigo on driving ability. 6–10,21–23…”