title: Psychoactive medications and crash involvement requiring hospitalization for older drivers: a population-based study.
abstract: OBJECTIVE
  To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.
  
  
  METHODS
  Retrospective population-based case-crossover study.
  
  
  METHODS
  A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.
authors: Curtin Monash Accident Research Centre, Curtin Health Innovation Research Centre, Curtin University, Perth, Western Australia, Australia. L.Meuleners@curtin.edu.au
authors: Lynn B
authors: LB
authors: Meuleners
authors: Janine
authors: J
authors: Duke
authors: Andy H
authors: AH
authors: Lee
authors: Peter
authors: P
authors: Palamara
authors: Janina
authors: J
authors: Hildebrand
authors: Jonathon Q
authors: JQ
authors: Ng
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects; D000928:Antidepressive Agents; D001334:Automobile Driving; D001569:Benzodiazepines / Q000009:adverse effects; D002908:Chronic Disease / Q000453:epidemiology; D018592:Cross-Over Studies; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D014904:Western Australia / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D000928:Antidepressive Agents; D011619:Psychotropic Drugs; D001569:Benzodiazepines