Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-25T16:44:12.791Z Has data issue: false hasContentIssue false

Psychiatric illness and driving: Irish psychiatrists' documentation practices

Published online by Cambridge University Press:  13 June 2014

Camilla Langan*
Affiliation:
General Adult Psychiatry, Department of Psychiatry, Clinical Science Institute, NUI Galway, Galway, Ireland
*
*Correspondence Email: [email protected]

Abstract

Objective: Psychiatric illness and the use of psychotropic medication are recognised as factors that may impair driving ability. Clinicians in the UK have a legal duty to advise patients on the effects of illness and prescribed medication on driving ability. Although clinicians in Ireland have no equivalent legal obligations, good medical practice suggests that doctors should be aware of whether patients are active drivers, and issue appropriate advice, supported by adequate documentation in clinical notes.

Method: The initial phase of the study analysed 44 outpatient records and 48 discharge records to ascertain the level of documentation regarding driving status, and advice given to patients regarding the effect of illness or medication on driving ability. The second phase involved distribution of an anonymous questionnaire to 18 psychiatrists employed in the acute psychiatric unit setting.

Results: Although there was minimal documentation regarding the potential effect of illness on driving ability, more than 50% of case notes revealed documented advice to patients regarding side-effects of medication and driving ability. Over 50% of case notes contained advice about medication compliance, but none contained cautionary advice about operating machinery. All psychiatrists admitted not being aware of the driving status of every patient they reviewed. Over 50% admitted to advising patients of the effect of illness or medication on driving ability, but fewer reported documenting this advice on every occasion. All psychiatrists reported that they would benefit from training in this area.

Conclusion: This study suggests that there is underdocumentation of advice given to patients regarding the effect of their symptoms or medication on driving ability. Clinicians need to improve their awareness of patients' driving status, in addition to receiving training on what their responsibilities are in this regard.

Type
Brief reports
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Harris, M. Psychiatric conditions with relevance to fitness to drive. Adv Psychiatr Treat 2000; 6: 261269.CrossRefGoogle Scholar
2.Gibbons, TCN. Mental illness, personality and behaviour disorders. In: PAB, Raffle, ed. Medical Aspects of Fitness to Drive. 3rd ed. London: Medical Commission on Accident Prevention, 1976: 3033.Google Scholar
3.Silverstone, T. Influence of psychiatric disease and its treatment on driving performance. Int Clin Psychopharmacol 1988; 3(Suppl 1): 5966.Google ScholarPubMed
4.Ohberg, A, Pentilla, A, Lonnqvist, J. Driver suicides. Br J Psychiatry 1997; 171: 468472.CrossRefGoogle ScholarPubMed
5.Road Safety Authority. 2008. 30% Drop in Road Deaths Since 1997; 2007, One of the Safest Years on Record. www.rsa.ie/NEWS/news/RSA_Year._End_07.html. Accessed 01 7, 2008.Google Scholar
6.Road Safety Authority. Rules of the Road. Dublin: Government Publications Office; 2007.Google Scholar
7.Ramaekers, JG. Antidepressants and driver impairment: empirical evidence from a standard on-the-road test. J Clin Psychiatry 2003; 64: 2029.CrossRefGoogle ScholarPubMed
8.Driver and Vehicle Licensing Agency (DVLA). At a glance guide to the current medical standards of fitness to drive. Swansea: DVLA, 2000.Google Scholar
9.General Medical Council. Confidentiality: Protecting and Providing Information. London: General Medical Council, 2004.Google Scholar
10.Royal College of Psychiatrists. Public Policy Committee guidance on medical aspects of fitness to drive. Psychiatr Bull 1996; 19: 747749.Google Scholar
11.Menard, I, Korner-Bitensky, N, Dobbs, Bet al.Canadian psychiatrists' current attitudes, practices, and knowledge regarding fitness to drive in individuals with mental illness: a cross-Canada survey. Can J Psychiatry 2006; 51(13): 836846.CrossRefGoogle ScholarPubMed
12.Rowe, R, Owen, A. Advice given to psychiatric inpatients concerning driving. Psychiatr Bull 2001; 25: 400401.CrossRefGoogle Scholar
13.Morgan, JF. Medical restrictions to driving: the awareness of patients and doctors. Postgrad Med J 2000; 76: 318320CrossRefGoogle ScholarPubMed