Implications of Driver and Vehicle Licensing Agency guidelines in an adult congenital heart disease population

Recent guidance from the Driver and Vehicle Licensing Agency states that symptomatic patients with congenital heart disease (CHD) should not drive and must notify the Driver and Vehicle Licensing Agency. ¹ We sought to understand the impact this new guidance would have upon our patients.

Methods

We designed and conducted a prospective survey regarding driving practices in adult CHD patients attending for outpatient review at a Level 1 surgical centre.

Results

In total, 103 consecutive patients completed the survey. The median age range was 25–34 years (total range 16–74 years). Overall, 48% of respondents were female. Thirty-four (33%) patients did not possess a driving licence, whilst 57 (55%) held a current driving licence and the other 12 (12%) were learning to drive. All of the drivers had a Group 1 licence (car/motorcycle); there were no Group 2 licence holders (bus/lorry). In total, 78% of drivers owned a car. Ten patients had a blue badge, whilst 12 patients were recipients of mobility allowance.

The main reasons for car usage were getting to work, visiting friends/family, and shopping (Fig 1a). Figure 1b demonstrates the use of public transport for all patients surveyed. Amongst those who drive, 19 (28%) never used public transport, with only 4 (6%) using it daily.

Figure 1. ( a ) Reasons for car usage amongst patients with driving licences/learning to drive. ( b ) Frequency of public transport utilisation in all patients surveyed.

Of the 69 patients with driving licences/learning to drive, 48 (70%) patients had previously undergone an operation. Thirty-three of these patients (48%) were prescribed cardiac medications. Two patients in total had an implantable cardioverter defibrillator, with one of these being a current driver. Forty-four (64%) patients with driving licences/learning to drive had symptoms within the last 6 months. The two most common symptoms were palpitations in 29 patients (42%) and exertional dyspnoea in 27 patients (39%).

In total, 35 (51%) licence holders/learners knew they could report their medical condition via the Driver and Vehicle Licencing Agency website. Twelve patients had contacted the Driver and Vehicle Licencing Agency about their heart condition and all of them found them to be helpful.

Conclusions

In total, 64% of our patients who drive had symptoms that according to the new Driver and Vehicle Licencing Agency guidance could preclude them from driving. Our survey results show our patients are reliant on driving for their daily activities. Therefore, the recent Driver and Vehicle Licencing Agency guidance is likely to result in significant social and financial difficulties for our patients and requires further clarification for such patients. We are designing an information leaflet for our patients to provide them with further advice and guidance upon these recent Driver and Vehicle Licencing Agency requirements.