Discussing driving concerns with older patients: I. vision care providers' attitudes and behaviors. 2013

Rebecca L Leinberger, and Nancy K Janz, and David C Musch, and Leslie M Niziol, and Brenda W Gillespie
Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI 48109, USA. Lemoyne@umich.edu

OBJECTIVE To investigate the perspectives of vision care providers (VCPs) on inquiring about driving among their older adult patients. METHODS We surveyed a stratified random sample of 500 VCPs, 404 of whom completed the survey (response rate, 80.8%), who had been identified using membership lists of the Michigan Optometric Association and the Michigan Society of Eye Physicians and Surgeons. The survey assessed VCPs' attitudes and behaviors in addressing driving concerns with older patients. Ordinal logistic regression analyses were performed to identify associations between provider or practice characteristics and survey responses. RESULTS More than 80% of VCPs are confident in their ability to determine whether their patients' vision is adequate for safe driving. The VCPs cite liability risk (for reporting [24.2%] and for not reporting [43.6%]) as a barrier to reporting unsafe drivers. Almost two-thirds report routinely inquiring about their older patients' driving, and 86.3% consider that counseling patients about driving is their responsibility. Almost 60% (57.2%) worry that reporting patients negatively influences the physician-patient relationship, and 43.1% consider that reporting is a breach of physician-patient confidentiality. Attitudes and behaviors in discussing driving varied by VCP characteristics, particularly provider type. More than one-third of VCPs (35.6%) report sometimes, often, or always communicating concerns about patients' driving to their primary care physician. Resources endorsed by VCPs as helpful or very helpful include driving assessment guidelines (80.5%), clinical screening instruments (70.1%), and patient self-assessment tools (59.9%). CONCLUSIONS While VCPs view that advising patients about driving is an important responsibility, further attention should be given to addressing barriers, providing resources, and devising communication strategies between VCPs and other members of the health care team.

UI MeSH Term Description Entries
D008297 Male Males
D008824 Michigan State bounded on the north by the Great Lakes, on the east by Canada, on the south by Wisconsin, Indiana, and Ohio, and on the west by Lake Michigan and Wisconsin.
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009885 Ophthalmology A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. Ocular Surgery,Ocular Surgeries,Surgery, Ocular
D009907 Optometry The professional practice of primary eye and vision care that includes the measurement of visual refractive power and the correction of visual defects with lenses or glasses. Optometries
D010817 Physician-Patient Relations The interactions between physician and patient. Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D010818 Practice Patterns, Physicians' Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided. Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D010819 Physician's Role The expected function of a member of the medical profession. Physicians' Role,Physician Role,Physician's Roles,Physicians Role,Physicians' Roles,Role, Physician's,Role, Physicians',Roles, Physician's,Roles, Physicians'
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D003142 Communication The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups. Miscommunication,Misinformation,Social Communication,Communication Programs,Communications Personnel,Personal Communication,Communication Program,Communication, Personal,Communication, Social,Communications, Social,Miscommunications,Misinformations,Personnel, Communications,Program, Communication,Programs, Communication,Social Communications

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