Driver licensing rates and motor vehicle crash risk among adolescents with attention deficit hyperactivity disorder
methods: We utilized electronic health records (EHR) to identify 15,854 NJ residents born 1987-1995 who were patients of CHOP’s NJ primary care practices within 4 years of driving-eligible age. Records were individually linked to NJ’s licensing and crash databases through June 2012. Subjects were classified as having ADHD if their EHR indicated an ICD-9-CM code beginning with ‘314’ either at a specific clinical encounter at CHOP or on the list of known chronic conditions. Licensing rates and crash risk were compared for 2,055 teens with and 13,799 teens without ADHD.
results: Adolescents with ADHD were less likely to be licensed by their 19th birthday (75% vs. 84%, p<0.001). Among those licensed, males with ADHD had a higher crash risk by 1 year (23% vs 19%, RR=1.26 [1.09-1.45]) and 3 years (52% vs. 41%, RR=1.48 [1.29, 1.71]) post-licensure. Females with and without ADHD had similar risks within 1 year of licensure (19% vs 18%, RR=1.07 [0.81-1.39]), but females with ADHD were at increased risk by 3 years post-licensure (49% vs 40%, RR=1.42 [1.10, 1.83]).
conclusions: Teens with ADHD are less likely to become licensed and may be at higher crash risk once licensed. Additional research is needed to understand the specific mechanisms by which ADHD influences crash risk.
Public health or related research
Compare the rate of licensure among primary care patients of a large, regional pediatric healthcare network with and without ADHD. Assess the relative risk of crash involvement between these two groups.
Keyword(s): Child/Adolescent Mental Health, Transportation
Qualified on the content I am responsible for because: I am an experienced independent investigator who leads a program of research related to the prevention of motor vehicle crashes involving children and adolescents. I currently serve as Principal Investigator of an NIH-funded R01 grant to conduct a longitudinal study examining the risk of adverse driving outcomes among adolescents and young adults with ADHD.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.