title: Assessment of patients' medical fitness to drive by primary care physicians: A cross-sectional study.
abstract: Motor vehicle collisions (MVCs) are a significant health burden in Saudi Arabia. The literature has consistently indicated that chronic medical conditions, such as diabetes, heart disease, stroke, obstructive sleep apnea, and neurodevelopmental disorders, increase the risk of MVCs. Therefore, assessment of driver fitness by primary care physicians (PCPs) remains a major health intervention that might reduce MVCs. We studied the practices of PCPs in assessing medical fitness to drive in at-risk patients.
  
  
  
  We conducted a cross-sectional study of all 88 government-funded primary care centers in the city of Riyadh, Saudi Arabia. We administered a self-reported questionnaire to PCPs that inquired about their driving risk assessment for specific medical conditions.
  
  
  
  Among all PCPs and centers, 189 PCPs (63%) from 74 centers (84%) participated in our survey. The mean age of the PCPs was 40 ± 10 years, and 108 (57%) were men. The average clinical experience of the group was 13 ± 9 years. Fewer than half of PCPs considered diabetes mellitus (45%) and obstructive sleep apnea (46%) as potential risks for MVCs. Approximately 45% of PCPs did not notify any authority or relatives of potential driving issues that they noticed in their patients. Only 15% of the participants believed that PCPs were responsible for alerting authorities about their fitness to drive.
  
  
  
  PCPs did not adequately assess their patients' driving history and eligibility. Efforts are needed to improve awareness among PCPs regarding the effects of chronic medical conditions on driving.
authors.affiliation: a University Sleep Disorders Center , Department of Medicine, College of Medicine, King Saud University , Riyadh , Saudi Arabia.
authors.forename: Ghassan A
authors.initials: GA
authors.lastname: Alkharboush
authors.affiliation: a University Sleep Disorders Center , Department of Medicine, College of Medicine, King Saud University , Riyadh , Saudi Arabia.
authors.forename: Faisal A
authors.initials: FA
authors.lastname: Al Rashed
authors.affiliation: a University Sleep Disorders Center , Department of Medicine, College of Medicine, King Saud University , Riyadh , Saudi Arabia.
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Saleem
authors.affiliation: a University Sleep Disorders Center , Department of Medicine, College of Medicine, King Saud University , Riyadh , Saudi Arabia.
authors.forename: Ibrahim S
authors.initials: IS
authors.lastname: Alnajashi
authors.affiliation: b Department of Family and Community Medicine , College of Medicine, King Saud University , Riyadh , Saudi Arabia.
authors.forename: Aljohara S
authors.initials: AS
authors.lastname: Almeneessier
authors.affiliation: a University Sleep Disorders Center , Department of Medicine, College of Medicine, King Saud University , Riyadh , Saudi Arabia.
authors.forename: Awad H
authors.initials: AH
authors.lastname: Olaish
authors.affiliation: c Trauma, Emergency & Critical Care Program, Sunnybrook Research Institute , Sunnybrook Health Sciences Centre , Toronto , Ontario , Canada.
authors.forename: Junaid A
authors.initials: JA
authors.lastname: Bhatti
authors.affiliation: a University Sleep Disorders Center , Department of Medicine, College of Medicine, King Saud University , Riyadh , Saudi Arabia.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: BaHammam
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data; D000328:Adult; D001334:Automobile Driving; D002908:Chronic Disease; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D058007:Physicians, Primary Care / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012529:Saudi Arabia
keywords: fitness to drive; motor vehicle collision; primary care; road traffic accidents; road traffic injuries; sleepiness