Psychoactive medications and crash involvement requiring hospitalization for older drivers: a population-based study.

OBJECTIVES

To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.

DESIGN

Retrospective population-based case-crossover study.

SETTING

A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.

PARTICIPANTS

Six hundred sixteen individuals aged 60 and older who were hospitalized as the result of a motor vehicle crash between 2002 and 2008 in Western Australia.

MEASUREMENTS

Hospitalization after a motor vehicle crash.

RESULTS

Greater risk for a hospitalization crash was found for older drivers prescribed benzodiazepines (odds ratio (OR)=5.3, 95% confidence interval (CI)=3.6-7.8, P<.001), antidepressants (OR=1.8, 95% CI=1.0-3.3, P=.04), and opioid analgesics (OR=1.5, 95% CI=1.0-2.3, P=.05). Crash risk was significantly greater in men prescribed a benzodiazepine (OR=6.2, 95% CI=3.2-12.2, P<.001) or an antidepressant (OR=2.7, 95% CI=1.1-6.9, P=.03). Women prescribed benzodiazepines (OR=4.9, 95% CI=3.1-7.8, P<.001) or opioid analgesics (OR=1.8, 95% CI=1.1-3.0, P=.03) also had a significantly greater crash risk. Subgroup analyses further suggested that drivers with (OR=4.0, 95% CI=2.9-8.1, P<.001) and without (OR=6.0, 95% CI=3.8-9.5, P<.001) a chronic condition who were prescribed benzodiazepines were at greater crash risk. Drivers with a chronic condition taking antidepressants (OR=3.4, 95% CI=1.3-8.5, P=.01) also had a greater crash risk.

CONCLUSION

Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.