Prevalence of Potentially Inappropriate Medication use in older drivers

BMC Geriatr. 2019 Oct 10;19(1):260. doi: 10.1186/s12877-019-1287-8.

Abstract

Background: Potentially Inappropriate Medication (PIM) use has been studied in a variety of older adult populations across the world. We sought to examine the prevalence and correlates of PIM use in older drivers.

Methods: We applied the American Geriatrics Society 2015 Beers Criteria to baseline data collected from the "brown-bag" review of medications for participants of the Longitudinal Research on Aging Drivers (LongROAD) study to examine the prevalence and correlates of PIM use in a geographically diverse, community-dwelling sample of older drivers (n = 2949). Proportions of participants who used one or more PIMs according to the American Geriatrics Society 2015 Beers Criteria, and estimated odds ratios (ORs) and 95% confidence intervals (CIs) of PIM use associated with participant characteristics were calculated.

Results: Overall, 18.5% of the older drivers studied used one or more PIM. The most commonly used therapeutic category of PIM was benzodiazepines (accounting for 16.6% of the total PIMs identified), followed by nonbenzodiazepine hypnotics (15.2%), antidepressants (15.2%), and first-generation antihistamines (10.5%). Compared to older drivers on four or fewer medications, the adjusted ORs of PIM use were 2.43 (95% CI 1.68-3.51) for those on 5-7 medications, 4.19 (95% CI 2.95-5.93) for those on 8-11 medications, and 8.01 (95% CI 5.71-11.23) for those on ≥12 medications. Older drivers who were female, white, or living in urban areas were at significantly heightened risk of PIM use.

Conclusion: About one in five older drivers uses PIMs. Commonly used PIMs are medications known to impair driving ability and increase crash risk. Implementation of evidence-based interventions to reduce PIM use in older drivers may confer both health and safety benefits.

Trial registration: Not applicable.

Keywords: Aging; Beers criteria; Driving safety; Older adults; Potentially inappropriate medications.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / drug effects*
  • Aging / psychology*
  • Automobile Driving / psychology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Geriatrics / methods
  • Humans
  • Inappropriate Prescribing / prevention & control*
  • Inappropriate Prescribing / psychology*
  • Independent Living / psychology
  • Independent Living / trends
  • Longitudinal Studies
  • Male
  • Potentially Inappropriate Medication List*
  • Prevalence
  • Prospective Studies