Grant: Operating Grant: Knowledge to Action

Background. The goal of this study is to adapt and evaluate a tool to help physicians decide when a patient with mild dementia should be reported to transportation authorities because their dementia has made them unsafe to drive. This is a growing concern given the increasing senior population in which both car accidents and dementia are seen in greater numbers. Physicians often do not comply with legislation that requires them to report patients with medical conditions affecting driving to transportation authorities. This is often because of a reluctance to interfere with the patient's independence and concerns about negative impact on the doctor-patient relationship. Research Plan. This study aims to test and evaluate a new Driving in Mild Dementia Decision Tool (DMD-DT). This tool will include a computer program to help physicians make decisions about reporting to transportation authorities as well as an individualized educational package for patients and their families. Doctors will be assigned to one of two groups - the DMD-DT group or a control group. Physicians in the DMD-DT group will receive guidance from the computer program on the decision-making process as well as a personalized educational package for patients and caregivers. In contrast, physicians in the control group will only be given a reminder of the mandatory reporting legislation. The main outcomes of the study include whether the physician reports the higher-risk patients to transportation authorities, and the impact on the doctor-patient relationship. Public Health Impact. The DMD-DT will streamline physician decision-making about driving in dementia and increase the reporting of unsafe drivers. This will lead to more appropriate decision-making, not punishing safe drivers, and improved public safety through fewer crashes by unfit drivers with dementia. The study will take place in Ontario but the DMD-DT will be adapted to other provinces with mandatory reporting legislation.