Prescription Medicines and the Risk of Road Traffic Crashes: A French Registry-Based Study

Abstract

Using three nationwide databases in France, Ludivine Orriols, Emmanuel Lagarde, and colleagues provide evidence that prescribed medicines contribute to the risk of experiencing a road traffic crash.

How Effective Are Pictograms in Communicating Risk About Driving-Impairing Medicines?

“…The present study, however, focuses on the use of pictograms in the field of medicines and driving and, to the best of our knowledge, it is one of the few (Orriols et al 2010;Veldhuijzen et al 2006) in this field and the first one to evaluate the use of such pictograms. Another important strength of the present study is the high response rate and good design.…”

“…Some European countries have already developed pictograms showing the potential risk of driving-impairing medicines (Gómez-Talegón et al 2011) but only in France (French Ministry of Health and Solidarity 2005) and Spain (Spanish Ministry of Health, Social Services and Equality 2007) is the use of pictograms on the package of such medicines legally binding. France is the only country where a 3-tier labeling system was developed and printed on the box of all medicines depending on their level of risk (categories 1 to 3, Figure 1; Agence française de sécurité sanitaire des produits de santé 2009; Orriols et al 2010), which can be seen as an advantage when compared to other pictograms that make no distinction between different levels of risk. However, the pictogram system existing in France (referred to as triangle model pictogram from this point forward) had the disadvantage of not showing all levels of risk in one picture.…”

The Spanish pictogram on medicines and driving: The population's comprehension of and attitudes towards its use on medication packaging

“…The use of medicines has been associated with an increase in the risk of involvement in traffic accidents (Orriols et al, 2009(Orriols et al, , 2010Engeland et al, 2007). For several years, there have been numerous attempts to classify medications according to the degree of deterioration that they may produce in fitness to drive (Ravera et al, 2012).…”

“…It is compulsory for pharmaceutical companies in the European Union to provide data concerning the effects of each medication on patients' ability to drive and use machines, prior to commercialisation (Summary of Product Characteristics, Section 4.7) (ECD, 1983) The insert provided in a medicine's packaging (ECD, 1983) contains information warning of the possible effects patients may notice when driving or handling dangerous machinery, since there is ample evidence that some of the adverse reactions to medications (somnolence, dizziness, blurred vision) may considerably reduce fitness to drive and increasing the risk of involvement in accidents (Orriols et al, 2009(Orriols et al, , 2010Engeland et al, 2007). However, not all users of a medicine read the package insert (Bernardini et al, 2000;Nathan et al, 2007), and many users do not consider the package insert to be very comprehensible (Barrio-Cantalejo et al, 2008).…”

Benzodiazepines, Posttraumatic Stress Disorder, and Veterans: Good News and Why We’re Not Done Yet

“…13 Approximately 81,000 of these visits resulted in a hospital admission, and, notably, these emergency department visits exclude fatalities, suicide attempts, or accidental overdoses. Multiple studies demonstrate that users of benzodiazepines face an increased risk of causing a motor vehicle accident, 14 and combat veterans as a group face an elevated risk of accidental death by trauma, particularly from motor vehicle accidents. 15 Together, these safety issues provide good reason to avoid benzodiazepines in PTSD, particularly among younger combat veterans.…”