Occupational therapists' capacity-building needs related to older driver screening, assessment, and intervention: a Canadawide survey.

BACKGROUND: Older driver safety is a growing concern. We identified capacity-building needs of occupational therapists related to older driver screening, assessment, and intervention. METHOD: A Canadawide survey was undertaken involving 133 occupational therapists working with an older clientele. A standardized questionnaire elicited information regarding (1) actual practices related to older driver screening, assessment, and intervention; (2) perceived competence; and (3) need for continuing education. RESULTS: Occupational therapists were twice as likely to use screening tools rather than in-depth assessments (n = 79 vs. n = 37). Only 25 occupational therapists offered on-road assessment, and even fewer offered retraining (n = 11). Occupational therapists more often felt very competent in domains related to screening as opposed to assessment, and most were interested in continuing education. CONCLUSION: Driving services offered were primarily related to screening compared with assessment or intervention. Occupational therapists would benefit from driving-related professional training aimed at enhancing professional capacity in this arena.

Older driver retraining: an updated systematic review of evidence of effectiveness.

PROBLEM AND OBJECTIVE: The number of older drivers who might benefit from driver retraining is growing. A previous review on the effectiveness of older driver retraining included intervention studies up to 2004. The objective was to perform an updated systematic review of the effectiveness of older driver retraining for improving driving-related skills and reducing crash rates. METHOD: Articles published from 2004-2008 were grouped according to the intervention provided and outcome studied. Randomized clinical trials (RCTs) were appraised using the Physiotherapy Evidence Database (PEDro) Scale and scored for quality according to their internal validity. Each intervention's effectiveness was then rated and assigned a level of evidence by combining pre- and post- 2004 findings. RESULTS: Three RCTs and one matched-pairs cohort design met the inclusion criteria. There is strong evidence (Level 1a) that education combined with on-road training improves driving performance and moderate evidence (Level 1b) that it improves knowledge. There is moderate evidence (Level 1b) that physical retraining improves driving performance. There is moderate evidence (Level 1b) that an educational intervention curriculum alone is not effective in reducing crashes. SUMMARY: The updated evidence on the effectiveness of retraining aimed at older drivers is sufficiently encouraging to merit assertive health promotion actions regarding intervention and program planning. IMPACT ON INDUSTRY: These positive findings warrant a comprehensive plan that has both behavioral and monetary incentives encouraging older driver participation in programs aimed at driver safety.