Shifting gears: An inpatient medical record audit and post-discharge survey of return-to-driving following stroke/transient ischaemic attack

Aust Occup Ther J. 2017 Jun;64(3):264-272. doi: 10.1111/1440-1630.12359. Epub 2017 Feb 16.

Abstract

Background/aim: In Australia, all stroke survivors should not drive for four weeks and transient ischaemic attack (TIA) survivors should not drive for two weeks. This study investigates the provision of return-to-driving education in the acute hospital setting and the use of this education by a cohort of Australian patients who have experienced a mild stroke or TIA and who are discharged directly home from their acute hospital admission.

Methods: A medical record audit was conducted of stroke patients discharged home from a regional hospital in Australia. All audited patients were sent a post-discharge anonymous survey of their post-stroke driving behaviours.

Results: A total of 78 medical records were audited (32 women, 46 men; 15 TIA, 63 strokes). Mean age was 67.4 years (SD = 13.7, range 20-89 years). Only 27 (34.6%) patients had documented evidence that return-to-driving was discussed with them by a health professional, with only 10 (12.8%) having a restriction period documented. A total of 31 surveys were analysed (10 females, 21 males) and 20 participants had returned to driving. From 31 survivors of mild stroke/TIA, 21 recalled receiving advice on return-to-driving and seven resumed driving during the non-driving period of one month.

Conclusions: Inconsistencies exist in the documentation of return-to-driving management after acute stroke or TIA and it is unknown whether patients who lack documentation in their medical records were provided with education or not.

Keywords: automobile driving; cerebrovascular accident; occupational therapy; return-to-driving guidelines.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Australia
  • Automobile Driving / statistics & numerical data*
  • Female
  • Humans
  • Ischemic Attack, Transient / complications
  • Ischemic Attack, Transient / rehabilitation*
  • Length of Stay / statistics & numerical data
  • Male
  • Medical Records / statistics & numerical data
  • Middle Aged
  • Occupational Therapy / statistics & numerical data*
  • Patient Discharge / statistics & numerical data*
  • Patient Education as Topic / statistics & numerical data*
  • Risk Factors
  • Stroke Rehabilitation / statistics & numerical data*
  • Time Factors
  • Young Adult