Psychoactive medications and crash involvement requiring hospitalization for older drivers: A population-based study

Abstract

OBJECTIVES: To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.DESIGN: Retrospective population-based case-crossover study.SETTING: A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.PARTICIPANTS: 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.MEASUREMENTS: 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.CONCLUSION: Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.