Vision care providers' perspectives on inquiring about driving in older adults

Purpose: Despite the relationship between vision, aging and driving, there is a dearth of research investigating the attitudes and challenges faced by vision care providers (VCPs) regarding advising their patients about driving. Methods: We surveyed VCPs' attitudes and behaviors regarding inquiring about driving in their older patients. Membership lists of the Michigan Society of Eye Physicians and Surgeons and the Michigan Optometric Association were used to identify a stratified random sample of 500 VCPs (response rate 81%, n=404). Regression analyses were performed to identify associations with responses. Results: While over 80% of VCPs reported feeling confident in their ability to determine whether vision is adequate for safe driving, less than 40% believe VCPs are the most qualified professionals to identify unsafe drivers. The majority of VCPs (64%) report they routinely inquire about driving and consider counseling patients about driving one of their responsibilities. Approximately 57% were concerned that reporting patients would negatively impact the doctor-patient relationship and 43% think reporting is a breach of doctor-patient confidentiality. Roughly one third (34%) considered loss of their patient's quality of life a barrier to assessment. Resources that VCPs reported would be helpful include driving assessment guidelines (81%), clinical screening instruments (70%), and a patient self-evaluation tool (60%). VCP characteristics that increased the likelihood of seeking driving information included female gender, younger age, and general practice (vs. specialization). Conclusions: While VCPs view driving assessment as an important responsibility, addressing barriers and providing useful resources deserves further attention.