Background: Canadian physicians are responsible for assessing medical fitness to drive; however, national data indicate that physicians lack confidence in performing such assessments and face numerous barriers to addressing driving in patients with dementia. We report on the impact of a provincial Web-based resource (www.notifbutwhen.ca) regarding driving cessation in dementia aimed towards primary care physicians (PCPs).
Methods: A pre/post cross-sectional survey (n = 134 baseline and n = 113 follow-up) of English-speaking, Nova Scotian PCPs. Descriptive statistics, chi-square, Pearson correlation, and multivariable logistic regression (controlling for sex, years of practice, and practice type) are reported.
Results: Most PCPs consider discussions regarding driving cessation to be routine part of dementia care; however, report multiple barriers to such discussions. Although the Web-based resource and awareness campaign were not associated with improvement in physician comfort in assessing driving risk in dementia, after completion of the campaign, fewer PCPs reported avoiding the topic of driving. Additionally, family resistance and lack of resources were less often reported as barriers.
Conclusions: Despite a lack of confidence, Nova Scotian PCPs routinely discuss driving cessation, and perform driving assessments for individuals with dementia. The Web-based resource and awareness campaign have shown moderate effectiveness in addressing specific barriers to assessment (e.g., caregiver resistance, lack of resources). Future efforts will address additional barriers, such as lack of comfort in decision-making.
Keywords: dementia; driving; driving assessment; primary care.