GP toolkit needed to assess older drivers

Assessing fitness to drive in older people is an increasingly important but challenging role for general practice. Some GPs are uncomfortable in this role, citing concerns about maintaining the patient-doctor relationship, and the impact driving cessation can have on an older person.  

A toolkit that provided an objective measure could help inform GP clinical judgement.

Such a toolkit would assist GPs in making an objective clinically judgement on whether an older driver needs further on-road testing or to give up driving completely. An objective measure could also be used by GPs as a communication tool and help to convey to an older person the need for further assessment or driving cessation, while maintaining relationships.  

Belgian researchers have developed a toolkit which includes measuring a patient’s visual ability with the Snellen chart, conducting a Functional Reach Test, and running a road signs recognition test (a component of the Stroke Drivers Screening Assessment). The benefit of this toolkit is that it tests three functional domains and could potentially be readily easily accessed in Australian general practice.

No toolkit will ever be perfect or sensitive. GPs will always need to use their clinical judgement. However, a toolkit that was validated for use in the Australian general practice context and generated an objective measure could support GPs when assessing fitness to drive in older people.

Right now, more research is needed to validate and test a toolkit that would be suitable for use in Australian general practice.

Associate Professor Katharine Wallis is a Gold Coast GP and academic at the University of Queensland’s Primary Care Clinical Unit.