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Original article

Vol. 151 No. 4344 (2021)

Attitude of Swiss general practitioners to mandatory training in assessing fitness to drive of older drivers

  • Philip Grob
  • Matthias Pfäffli
DOI
https://doi.org/10.4414/SMW.2021.w30035
Cite this as:
Swiss Med Wkly. 2021;151:w30035
Published
28.10.2021

Summary

 

AIMS OF THE STUDY: In Switzerland, drivers over the age of 75 must undergo a medical assessment of their fitness to drive every 2 years. This assessment is usually carried out by a general practitioner (GP). Since 2016, physicians require official accreditation (so-called level 1 competence) to perform these examinations. This can be obtained either by self-declaration of competence or by attending an accredited training course. Little is known about the Swiss GPs' views on this regulation. In this study, we investigated the attitude of GPs towards these modalities.

METHODS: A questionnaire was mailed to 2372 GPs in a large part of German-speaking Switzerland, 1198 of whom completed and returned the questionnaire. The anonymised data were analysed by descriptive statistics (frequencies, percentages) to summarise participant demographics and agreement with attitudinal statements.

RESULTS: The response rate was 50.5%. Sociodemographic data (age, gender, settlement area) of the participating GPs corresponded to those of the Swiss medical statistics. The majority (93.1%) of respondents worked in an outpatient setting, 6.9% in the inpatient sector. Overall, 34.4% of the GPs completed a training course and 47.7% submitted a self-declaration in order to acquire level 1 competence. Older and more experienced physicians had made more use of the self-declaration option. 58.1% of the respondents would like to retain the existing regulations. Of the respondents who had attended a training course, 51.7% considered themselves more competent in the assessment of older drivers after the training, and 76.1% would like to maintain the course duration of 1 day. Of the physicians surveyed, 70.8%  were of the opinion that level 1 examinations are a useful screening tool for older drivers who are unfit to drive, and 78.4% agreed that MFTD (medical fitness to drive) examinations of older drivers should be performed by GPs.

CONCLUSIONS: In Switzerland, the currently existing regulation for acquiring level 1 competence is widely accepted by GPs. Almost all respondents considered that they have sufficient knowledge to assess MFTD. However, the majority of GPs who had attended the training course indicated they have benefited from it. Periodic assessment of MFTD of older drivers was considered useful and should preferably be performed by GPs. These results show that the periodic assessment of older drivers' MFTD practised in Switzerland is well accepted.

References

  1. Vespa J, Armstrong DM, Medina L. Demographic Turning Points for the United States: Population Projections for 2020 to 2060. Current Population Reports. Washington, DC: U.S. Census Bureau, 2018 2018/03. Report No.: P25-1144.
  2. Dobbs BM. Aging baby boomers—a blessing or challenge for driver licensing authorities. Traffic Inj Prev. 2008 Aug;9(4):379–86. https://doi.org/10.1080/15389580802045823
  3. Führerausweisbesitz nach Geschlecht und Alter (Daten zu G2.1.1.1 des MZMV-Berichts 2015) [Internet]. Neuchâtel, Switzerland: Federal Statistical Office. 2017 [cited 2018 May 02]. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/mobilitaet-verkehr/personenverkehr/verkehrsverhalten/besitz-fahrzeuge-fahrausweise.assetdetail.2480142.html
  4. Musselwhite CB, Shergold I. Examining the process of driving cessation in later life. Eur J Ageing. 2012 Nov;10(2):89–100. https://doi.org/10.1007/s10433-012-0252-6
  5. Zhao C, Wong L, Zhu Q, Yang H. Prevalence and correlates of chronic diseases in an elderly population: A community-based survey in Haikou. PLoS One. 2018 Jun;13(6):e0199006. https://doi.org/10.1371/journal.pone.0199006
  6. Vernon DD, Diller EM, Cook LJ, Reading JC, Suruda AJ, Dean JM. Evaluating the crash and citation rates of Utah drivers licensed with medical conditions, 1992-1996. Accid Anal Prev. 2002 Mar;34(2):237–46. https://doi.org/10.1016/S0001-4575(01)00019-7
  7. Kereszty ÉM, Julesz M. Medical fitness to drive in the EU with special reference to the age factor. Rechtsmedizin. 2018;28(4):288–94. https://doi.org/10.1007/s00194-018-0247-5
  8. Siren A, Haustein S. Driving licences and medical screening in old age: review of literature and European licensing policies. J Transp Health. 2015;2(1):68–78. https://doi.org/10.1016/j.jth.2014.09.003
  9. The Federal Authorities of the Swiss Confederation. Appendix of the ordinance of 27 October 1976 on the admission of persons and vehicles to road traffic (Verkehrszulassungsverordnung, VZV), 741.51 (01.01.2021). Available from: https://www.fedlex.admin.ch/eli/cc/1976/2423_2423_2423/de
  10. www.medtraffic.ch. [Web Page]. [cited 22.03.2021]. Available from: https://medtraffic.ch/
  11. Hostettler S, Kraft E. FMH-Ärztestatistik 2018. Schweiz Arzteztg. 2019;100(12):411–6. https://doi.org/10.4414/saez.2019.17687
  12. Online database of Swiss Physicians [Internet]. FMH. 2018 [cited 02.05.2018]. Available from: https://www.doctorfmh.ch/
  13. FMH-Ärztestatistik [Internet]. FMH. 2018 [cited 22.03.2019]. Available from: https://aerztestatistik.myfmh2.fmh.ch/
  14. Marshall SC, Gilbert N. Saskatchewan physicians’ attitudes and knowledge regarding assessment of medical fitness to drive. CMAJ. 1999 Jun;160(12):1701–4.
  15. Hanson TR, Hildebrand ED. Can rural older drivers meet their needs without a car? Stated adaptation responses from a GPS travel diary survey. Transportation. 2011;38(6):975–92. https://doi.org/10.1007/s11116-011-9323-3
  16. Kahvedžić A, Mcfadden R, Cummins G, Carr D, O’Neill D. Impact of new guidelines and educational program on awareness of medical fitness to drive among general practitioners in Ireland. Traffic Inj Prev. 2015;16(6):593–8. https://doi.org/10.1080/15389588.2014.979408
  17. Omer S, Dolan C, Dimitrov BD, Langan C, McCarthy G. General practitioners’ opinions and attitudes towards medical assessment of fitness to drive of older adults in Ireland. Australas J Ageing. 2014 Sep;33(3):E33–6. https://doi.org/10.1111/ajag.12045
  18. Hawley CA, Galbraith ND, deSouza VA. Medical education on fitness to drive: a survey of all UK medical schools. Postgrad Med J. 2008 Dec;84(998):635–8. https://doi.org/10.1136/pgmj.2008.067959
  19. Lipski PS. A survey of general practitioners’ attitudes to older drivers on the New South Wales Central Coast. Australas J Ageing. 2002;21(2):98–100. https://doi.org/10.1111/j.1741-6612.2002.tb00425.x
  20. Eggert S, Thali MJ, Pfäffli M. Discretionary medical reporting of potentially unfit drivers: a questionnaire-based survey in southeast Switzerland. Int J Legal Med. 2012 Jan;126(1):71–8. https://doi.org/10.1007/s00414-011-0574-5
  21. Koppel S, Bugeja L, Stephens A, Cartwright A, Osborne R, Williams G, et al. The safety benefits of older drivers attending an in-person licence renewal. J Transp Health. 2020;17:100845. https://doi.org/10.1016/j.jth.2020.100845
  22. Sebo P, Haller DM, Favrat B, Huber P, Mueller Y, Vaucher P. Adherence to guidelines when evaluating fitness-to-drive in the elderly: a practice review of Swiss physicians. Swiss Med Wkly. 2018 Jul;148:w14632. https://doi.org/10.4414/smw.2018.14632
  23. Hakamies-Blomqvist L, Henriksson P, Falkmer T, Lundberg C, Braekhus A. Attitudes of Primary Care Physicians Toward Older Drivers: A Finnish-Swedish Comparison. J Appl Gerontol. 2002;21(1):58–69. https://doi.org/10.1177/0733464802021001005