“I Wish We Could Normalize Driving Health:” A Qualitative Study of Clinician Discussions with Older Drivers

Betz, Marian E.; Jones, Jacqueline; Petroff, E.; Schwartz, Robert S.

doi:10.1007/s11606-013-2498-x

Cited by 65 publications

(74 citation statements)

References 33 publications

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“…An overly patronizing approach to motor vehicle traffic safety, therefore, might further compromise a doctor-patient relationship and lessen patient well-being 47 . At present, physician warnings for medically unfit motorists can be effective for improving driving safety in older patients and are mandatory in several regions of North America 48,49 .…”

Section: Rheumatologymentioning

confidence: 99%

Fibromyalgia and the Risk of a Subsequent Motor Vehicle Crash

Redelmeier

Zung²,

Thiruchelvam³

et al. 2015

J Rheumatol

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Section: Rheumatologymentioning

confidence: 99%

Fibromyalgia and the Risk of a Subsequent Motor Vehicle Crash

Redelmeier

Zung²,

Thiruchelvam³

et al. 2015

J Rheumatol

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“…41617 Explanations include: physician discomfort, fear of patient alienation, and inadequate training; 1819 competing priorities with limited time; 4 driver assessment tools that may be too long for practical routine use; 120 fear of liability; 5 and inadequate options for testing or alternative transportation. 321 Regulations concerning physician assessment or reporting of fitness-to-drive vary widely among states; 22 in Colorado, for example, physicians are able, but not mandated, to report potentially unsafe drivers and they receive liability coverage for any reports make in good faith (but non-physicians are not similarly covered).…”

Section: Introductionmentioning

confidence: 99%

System facilitators and barriers to discussing older driver safety in primary care settings

2015

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Background Primary care physicians play a leading role in counseling older drivers, but discussions often do not occur until safety concerns arise. Prior work suggests that routine questioning about driving might facilitate these difficult conversations. Objective To explore system-level factors affecting driving discussions in primary care settings, in order to inform the design and implementation of a program supporting routine conversations. Methods This qualitative descriptive study used iterative interviews with providers (physicians, nurses, medical assistants, social workers, and administrative staff) working at two clinics (one geriatric, one general internal medicine) at a tertiary-care teaching hospital. General inductive techniques in transcript analysis were used to identify stakeholder-perceived system-level barriers and facilitators to routine conversations with older drivers. Results From fifteen interviews, four themes emerged: (1) complexity of defined provider roles within primary care setting (which can both support team work and hamper efficiency); (2) inadequate resources to support providers (including clinical prompts, local guides, and access to social workers and driving specialists); (3) gaps in education of providers and patients about discussing driving; and (4) suggested models to enhance provider conversations with older drivers (including following successful examples and using defined pathways integrated into the electronic medical record). A fifth theme was that participants characterized their experiences in terms of current and ideal states. Conclusions Physicians have been tasked with assessing older driver safety and guiding older patients through the process of “driving retirement.” Attention to system-level factors such as provider roles, resources, and training can support them in this process.

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“…B etz et al 1 used qualitative focus groups and semistructured interviews to explore the roles and responsibilities of providers, patients, and caregivers when discussing driving cessation due to age-related impairment. They found that both providers and older drivers prefer to discuss stopping driving preventatively, rather than after a driving-related incident.…”

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confidence: 99%

Capsule Commentary on Betz et al., “I Wish We Could Normalize Driving Health”: A Qualitative Study of Clinician Discussions with Older Drivers

Koenig

2013

J GEN INTERN MED

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“I Wish We Could Normalize Driving Health:” A Qualitative Study of Clinician Discussions with Older Drivers

Cited by 65 publications

References 33 publications

Fibromyalgia and the Risk of a Subsequent Motor Vehicle Crash

Fibromyalgia and the Risk of a Subsequent Motor Vehicle Crash

System facilitators and barriers to discussing older driver safety in primary care settings

Capsule Commentary on Betz et al., “I Wish We Could Normalize Driving Health”: A Qualitative Study of Clinician Discussions with Older Drivers

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