Psychoactive medications and crash involvement requiring hospitalization for older drivers: a population-based study

Lynn B Meuleners; Janine Duke; Andy H Lee; Peter Palamara; Janina Hildebrand; Jonathon Q Ng

doi:10.1111/j.1532-5415.2011.03561.x

Psychoactive medications and crash involvement requiring hospitalization for older drivers: a population-based study

Lynn B Meuleners
, Janine Duke
, Andy H Lee
, Peter Palamara
, Janina Hildebrand
, Jonathon Q Ng

Research output: Contribution to journal › Article › peer-review

61 Citations (Scopus)

Abstract

OBJECTIVES: To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.

DESIGN: Retrospective population-based case-crossover study.

SETTING: A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.

PARTICIPANTS: Six hundred sixteen individuals aged 60 and older who were hospitalized as the result of a motor vehicle crash between 2002 and 2008 in Western Australia.

MEASUREMENTS: Hospitalization after a motor vehicle crash.

RESULTS: Greater risk for a hospitalization crash was found for older drivers prescribed benzodiazepines (odds ratio (OR)=5.3, 95% confidence interval (CI)=3.6-7.8, P<.001), antidepressants (OR=1.8, 95% CI=1.0-3.3, P=.04), and opioid analgesics (OR=1.5, 95% CI=1.0-2.3, P=.05). Crash risk was significantly greater in men prescribed a benzodiazepine (OR=6.2, 95% CI=3.2-12.2, P<.001) or an antidepressant (OR=2.7, 95% CI=1.1-6.9, P=.03). Women prescribed benzodiazepines (OR=4.9, 95% CI=3.1-7.8, P<.001) or opioid analgesics (OR=1.8, 95% CI=1.1-3.0, P=.03) also had a significantly greater crash risk. Subgroup analyses further suggested that drivers with (OR=4.0, 95% CI=2.9-8.1, P<.001) and without (OR=6.0, 95% CI=3.8-9.5, P<.001) a chronic condition who were prescribed benzodiazepines were at greater crash risk. Drivers with a chronic condition taking antidepressants (OR=3.4, 95% CI=1.3-8.5, P=.01) also had a greater crash risk.

CONCLUSION: Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.

Original language	English
Pages (from-to)	1575-80
Number of pages	6
Journal	Journal of the American Geriatrics Society
Volume	59
Issue number	9
DOIs	https://doi.org/10.1111/j.1532-5415.2011.03561.x
Publication status	Published - Sept 2011

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This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.1111/j.1532-5415.2011.03561.x

Cite this

@article{f9165dedb7b541c2a930560ada856027,

title = "Psychoactive medications and crash involvement requiring hospitalization for older drivers: a population-based study",

abstract = "OBJECTIVES: To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.DESIGN: Retrospective population-based case-crossover study.SETTING: A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.PARTICIPANTS: Six hundred sixteen individuals aged 60 and older who were hospitalized as the result of a motor vehicle crash between 2002 and 2008 in Western Australia.MEASUREMENTS: Hospitalization after a motor vehicle crash.RESULTS: Greater risk for a hospitalization crash was found for older drivers prescribed benzodiazepines (odds ratio (OR)=5.3, 95\% confidence interval (CI)=3.6-7.8, P<.001), antidepressants (OR=1.8, 95\% CI=1.0-3.3, P=.04), and opioid analgesics (OR=1.5, 95\% CI=1.0-2.3, P=.05). Crash risk was significantly greater in men prescribed a benzodiazepine (OR=6.2, 95\% CI=3.2-12.2, P<.001) or an antidepressant (OR=2.7, 95\% CI=1.1-6.9, P=.03). Women prescribed benzodiazepines (OR=4.9, 95\% CI=3.1-7.8, P<.001) or opioid analgesics (OR=1.8, 95\% CI=1.1-3.0, P=.03) also had a significantly greater crash risk. Subgroup analyses further suggested that drivers with (OR=4.0, 95\% CI=2.9-8.1, P<.001) and without (OR=6.0, 95\% CI=3.8-9.5, P<.001) a chronic condition who were prescribed benzodiazepines were at greater crash risk. Drivers with a chronic condition taking antidepressants (OR=3.4, 95\% CI=1.3-8.5, P=.01) also had a greater crash risk.CONCLUSION: Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.",

keywords = "Accidents, Traffic/statistics \& numerical data, Aged, Aged, 80 and over, Analgesics, Opioid/adverse effects, Antidepressive Agents, Automobile Driving, Benzodiazepines/adverse effects, Chronic Disease/epidemiology, Cross-Over Studies, Databases, Factual, Female, Hospitalization/statistics \& numerical data, Humans, Male, Middle Aged, Psychotropic Drugs/adverse effects, Retrospective Studies, Risk Factors, Western Australia/epidemiology",

author = "Meuleners, \{Lynn B\} and Janine Duke and Lee, \{Andy H\} and Peter Palamara and Janina Hildebrand and Ng, \{Jonathon Q\}",

year = "2011",

month = sep,

doi = "10.1111/j.1532-5415.2011.03561.x",

language = "English",

volume = "59",

pages = "1575--80",

journal = "Journal of the American Geriatrics Society",

issn = "0002-8614",

publisher = "John Wiley \& Sons",

number = "9",

}

TY - JOUR

T1 - Psychoactive medications and crash involvement requiring hospitalization for older drivers

T2 - a population-based study

AU - Meuleners, Lynn B

AU - Duke, Janine

AU - Lee, Andy H

AU - Palamara, Peter

AU - Hildebrand, Janina

AU - Ng, Jonathon Q

PY - 2011/9

Y1 - 2011/9

N2 - OBJECTIVES: To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.DESIGN: Retrospective population-based case-crossover study.SETTING: A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.PARTICIPANTS: Six hundred sixteen individuals aged 60 and older who were hospitalized as the result of a motor vehicle crash between 2002 and 2008 in Western Australia.MEASUREMENTS: Hospitalization after a motor vehicle crash.RESULTS: Greater risk for a hospitalization crash was found for older drivers prescribed benzodiazepines (odds ratio (OR)=5.3, 95% confidence interval (CI)=3.6-7.8, P<.001), antidepressants (OR=1.8, 95% CI=1.0-3.3, P=.04), and opioid analgesics (OR=1.5, 95% CI=1.0-2.3, P=.05). Crash risk was significantly greater in men prescribed a benzodiazepine (OR=6.2, 95% CI=3.2-12.2, P<.001) or an antidepressant (OR=2.7, 95% CI=1.1-6.9, P=.03). Women prescribed benzodiazepines (OR=4.9, 95% CI=3.1-7.8, P<.001) or opioid analgesics (OR=1.8, 95% CI=1.1-3.0, P=.03) also had a significantly greater crash risk. Subgroup analyses further suggested that drivers with (OR=4.0, 95% CI=2.9-8.1, P<.001) and without (OR=6.0, 95% CI=3.8-9.5, P<.001) a chronic condition who were prescribed benzodiazepines were at greater crash risk. Drivers with a chronic condition taking antidepressants (OR=3.4, 95% CI=1.3-8.5, P=.01) also had a greater crash risk.CONCLUSION: Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.

AB - OBJECTIVES: To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.DESIGN: Retrospective population-based case-crossover study.SETTING: A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.PARTICIPANTS: Six hundred sixteen individuals aged 60 and older who were hospitalized as the result of a motor vehicle crash between 2002 and 2008 in Western Australia.MEASUREMENTS: Hospitalization after a motor vehicle crash.RESULTS: Greater risk for a hospitalization crash was found for older drivers prescribed benzodiazepines (odds ratio (OR)=5.3, 95% confidence interval (CI)=3.6-7.8, P<.001), antidepressants (OR=1.8, 95% CI=1.0-3.3, P=.04), and opioid analgesics (OR=1.5, 95% CI=1.0-2.3, P=.05). Crash risk was significantly greater in men prescribed a benzodiazepine (OR=6.2, 95% CI=3.2-12.2, P<.001) or an antidepressant (OR=2.7, 95% CI=1.1-6.9, P=.03). Women prescribed benzodiazepines (OR=4.9, 95% CI=3.1-7.8, P<.001) or opioid analgesics (OR=1.8, 95% CI=1.1-3.0, P=.03) also had a significantly greater crash risk. Subgroup analyses further suggested that drivers with (OR=4.0, 95% CI=2.9-8.1, P<.001) and without (OR=6.0, 95% CI=3.8-9.5, P<.001) a chronic condition who were prescribed benzodiazepines were at greater crash risk. Drivers with a chronic condition taking antidepressants (OR=3.4, 95% CI=1.3-8.5, P=.01) also had a greater crash risk.CONCLUSION: Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.

KW - Accidents, Traffic/statistics & numerical data

KW - Aged

KW - Aged, 80 and over

KW - Analgesics, Opioid/adverse effects

KW - Antidepressive Agents

KW - Automobile Driving

KW - Benzodiazepines/adverse effects

KW - Chronic Disease/epidemiology

KW - Cross-Over Studies

KW - Databases, Factual

KW - Female

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Male

KW - Middle Aged

KW - Psychotropic Drugs/adverse effects

KW - Retrospective Studies

KW - Risk Factors

KW - Western Australia/epidemiology

U2 - 10.1111/j.1532-5415.2011.03561.x

DO - 10.1111/j.1532-5415.2011.03561.x

M3 - Article

C2 - 21883110

SN - 0002-8614

VL - 59

SP - 1575

EP - 1580

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

IS - 9

ER -

Psychoactive medications and crash involvement requiring hospitalization for older drivers: a population-based study

Abstract

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