promoting safe driving strategies to older drivers with visual impairment does not reduce crash rate

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Evidence-Based Healthcare & Public Health (2004) 8, 292293 EVIDENCE-BASED PUBLIC HEALTH Promoting safe driving strategies to older drivers with visual impairment does not reduce crash rate $ Summary Question Does an individualised education programme, promoting safe driving strategies, reduce the crash rate of visually impaired older drivers? Study design Randomised controlled trial. Main results Crash rate. There were no significant differences in the crash rate between groups at two years (education vs. usual care: number of collisions 53/227 vs. 38/176, RR of crash per 100 person years of driving: 1.08; 95% CI 0.71 to 1.64; per million personmiles of travel: RR, 1.40; 95% CI 0.92 to 2.12). Self-regulation. Education increased self-reported avoidance of challenging driving manoeuvres and self-regulatory behaviour compared with usual care (p40.0001). Authors’ conclusions This educational programme did not reduce vehicle collision rates or increase the safety of older, visually impaired drivers. r 2004 Elsevier Ltd. All rights reserved. Study parameters Question Does an individualised education programme, promoting safe driving strategies, reduce the crash rate of visually impaired older drivers? Study design Randomised controlled trial. Setting Birmingham, Alabama, USA; timeframe not stated. Participants 403 older drivers (60+ years) with visual impairment, defined as visual acuity [habitual or binocular] between 20/30 and 20/60, or restriction in the useful field of view (scoring X 40% reduction, measured ARTICLE IN PRESS www.elsevier.com/locate/ebhph KEYWORDS Education; Traffic accidents; Accident prevention; Vision disorders; Driver-safety programs; Elderly; Randomised controlled trial 1744-2249/$ - see front matter r 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.ehbc.2004.08.021 $ Abstracted from: Owsley C, McGwin G, Phillips JM et al. Impact of an educational program on the safety of high-risk, visually impaired, older drivers. American Journal of Preventive Medicine 2004; 26: 222229.

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Page 1: Promoting safe driving strategies to older drivers with visual impairment does not reduce crash rate

ARTICLE IN PRESS

Evidence-Based Healthcare & Public Health (2004) 8, 292–293

KEYWORDEducation;Traffic accAccident pVision disoDriver-safeprograms;Elderly;Randomisecontrolled

1744-2249/$ - sdoi:10.1016/j.e

$Abstractedimpaired, older

www.elsevier.com/locate/ebhph

EVIDENCE-BASED PUBLIC HEALTH

Promoting safe driving strategies to olderdrivers with visual impairment does notreduce crash rate$

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idents;revention;rders;ty

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ee front matter r 200hbc.2004.08.021

from: Owsley C, McGwdrivers. American Jou

Summary

Question Does an individualised education programme, promoting safe drivingstrategies, reduce the crash rate of visually impaired older drivers?

Study design Randomised controlled trial.

Main results Crash rate. There were no significant differences in the crash ratebetween groups at two years (education vs. usual care: number of collisions 53/227vs. 38/176, RR of crash per 100 person years of driving: 1.08; 95% CI 0.71 to 1.64; permillion person–miles of travel: RR, 1.40; 95% CI 0.92 to 2.12). Self-regulation.Education increased self-reported avoidance of challenging driving manoeuvres andself-regulatory behaviour compared with usual care (p40.0001).

Authors’ conclusions This educational programme did not reduce vehicle collisionrates or increase the safety of older, visually impaired drivers.r 2004 Elsevier Ltd. All rights reserved.

Study parameters

Question

Does an individualised education programme, promoting safe driving strategies, reduce the crash rate ofvisually impaired older drivers?

Study design

Randomised controlled trial.

Setting

Birmingham, Alabama, USA; timeframe not stated.

Participants

403 older drivers (60+ years) with visual impairment, defined as visual acuity [habitual or binocular]between 20/30 and 20/60, or restriction in the useful field of view (scoring X 40% reduction, measured

4 Elsevier Ltd. All rights reserved.

in G, Phillips JM et al. Impact of an educational program on the safety of high-risk, visuallyrnal of Preventive Medicine 2004; 26: 222–229.

Page 2: Promoting safe driving strategies to older drivers with visual impairment does not reduce crash rate

ARTICLE IN PRESS

EVIDENCE-BASED PUBLIC HEALTH 293

with useful field of view test, or both) and who had been the driver in a crash in the previous year.Participants drove at least five days or 100 miles per week, or both.

Intervention

Usual care (comprehensive eye examination) or usual care plus educational intervention (two ‘one on one’sessions with a health educator specialising in driver safety and gerontology).

Main outcomes

Crash involvement over the following two years, expressed as rate of person-years of follow-up or person-miles of travel. Driving exposure information was collected by telephone at six-month intervals.Information on collisions was obtained from the Alabama Department of Public Safety. Participantscompleted questionnaires on self–regulation activities (e.g. avoiding turns across traffic, rush hour, nightdriving).

Notes

There was complete follow-up of 349 out of 403 (87%) participants.

Sources of funding: General Motors Corporation, Research to prevent blindness, Inc., and the EyeSightFoundation of Alabama.

Abstract provided by Bazian Ltd, London