Evaluating medically at-risk drivers: a survey of assessment practices in Canada.

BACKGROUND

Assessing medical fitness to drive (FTD) can include both off- and on-road testing, although consistency of practice is unclear.

PURPOSE

To examine actual practices being used to assess FTD at driver assessment centres (DACs) across Canada.

METHOD

Surveys e-mailed to 90 DACs were returned by 47 assessors.

FINDINGS

The majority of respondents (89%) were occupational therapists. Assessors reported doing an average of eight FTD assessments per month (range = I to 40) at an average cost of $366 (SD = $225; range = $40 to $985). Referrals came from physicians (96%), other health professionals (70%), and licensing authorities (66%). Clients with stroke, dementia, traumatic brain injury, mild cognitive impairment, and multiple sclerosis composed 62% of estimated caseloads. Assessments took 3 hr on average (range = 1.24 to 4.5 hr); 64% reported they always took clients on road regardless of clinic results.

IMPLICATIONS

Evidence-based guidelines for training and assessment are clearly needed given the inconsistency in practice.