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David C. Musch, Nancy K. Janz, Rebecca L. Leinberger, Leslie M. Niziol, Brenda W. Gillespie; Assessing Driving in Older Adults: Information Being Obtained by Vision Care Providers. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1918.
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To describe the tests and information vision care providers (VCPs) most often use to assess driving capabilities of their elderly patients.
We developed a survey of VCPs’ attitudes and actions taken in assessing driving capabilities among their elderly patients. The survey was based on a conceptual model of health behavior, prior studies, and advice from content experts. Membership lists of the Michigan Society of Eye Physicians and Surgeons and the Michigan Optometric Association were used to identify a stratified random sample of 500 VCPs. Methods to maximize return rate were employed, yielding a response rate of 83% (415/500). Upon removing ineligible VCPs (n=7) and surveys returned blank (n=4), surveys from 404 VCPs (81%) were analyzed. Regression analyses were performed to identify associations with responses.
Based on responses of "often" or "always", the vision tests that VCPs reported to be most frequently used in assessing driving capabilities included visual acuity (99%), peripheral vision (82%), and visual field (66%). VCPs less frequently considered other medical conditions (49%) and medications that might affect driving (33%). Inquiries by VCPs about night driving, reading signs, and glare were very common (≥87%), whereas questioning about other driving challenges (merging, making left turns, and backing up) and the patient’s recent driving record were infrequent (<10%). Other than asking if patients wear their corrective lenses when driving (71% often/always), the VCPs usually did not inquire about other external conditions or resources [e.g., availability of a "co-pilot" (18%) or alternative transportation (23%)], nor did they usually ask about driving frequency or distance (20%). VCP characteristics that increased the likelihood of seeking driving information included female gender, younger age, and general practice (vs. specialization).
Key data that would enable VCPs to better assess their elderly patients’ problems with driving and to more effectively advise them on adjustments that may be necessary are often not obtained.
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