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Abstract
OBJECTIVE: We aimed to explore the extent to which
general practitioners (GPs) in Western Switzerland adhere
to Swiss recommendations when assessing fitness-to-drive
in the elderly.
METHODS: A random sample of 500 GPs practicing in
Vaud, Neuchatel and Jura, and all GPs certified to conduct
fitness-to-drive assessments in Geneva (“experts”, n = 69)
were invited to participate. They were asked how often
they performed twenty procedures (recommended in
Swiss guidelines developed by experts in traffic medicine)
when assessing older drivers during the previous year,
scored on a five-point Likert scale ranging from “never” to
“always performed”. The GPs were considered to be adhering
to the recommended procedure if they performed it
often or always. We computed the proportion of GPs adhering
to each procedure, and compared GPs with or without
specialised expertise.
RESULTS: A total of 268 GPs completed the questionnaire
(participation rate 47%). The most frequently reported
procedures were asking for current medication (96%),
cardiovascular (94%) and neurological diseases (91%),
and screening for visual acuity impairment (93%), whereas
the least frequently reported procedures were screening
for cognitive impairment in drivers aged between 70
and 80 years (44%) and for mood disorder (31%), asking
for a history of driving license withdrawal (38%), and interviewing
close relatives (10%). Six procedures were statistically
significantly more frequently performed by the experts
than by the other GPs. In general, GPs reported
using validated tools, except when screening for at-risk
drinking and mood disorder (tools used by 26 and 28%,
respectively).
CONCLUSIONS: Many Swiss GPs seem not to systematically
follow the current Swiss recommendations. Although
several important procedures appear to routinely be part
of older drivers’ assessment, others are infrequently performed.
Further research should identify how GPs select
the recommended items to which they adhere and those
they never apply, and how to facilitate the use of recommended
procedures to help them decide if a person is fit,
unfit or requiring further evaluation.