Friday, 8 November 2013

Driving advice and MS

Are you aware that you have to notify the driving authorities if you have MS? #MSBlog #MSResearch

"The following survey shows you hoe poor the medical profession is in telling people with different neurological conditions about how their disease may impact on  their ability to drive a motor vehicle and their responsibility  to notify the driving authorities. To take this forward I have designed a short survey that I would appreciate you completing to assess how this affects readers of this blog with MS.  I would appreciate it if you could that 1 or 2 minutes to complete the survey. Thank you."


Wong SL, Sharrack B.A survey of advice on driving in neurological conditions amongst neurologists and neurosurgeons. J Neurol Neurosurg Psychiatry. 2013;84(11):e2.

BACKGROUND: Doctors have the duty of care to provide driving advice to patients with certain neurological conditions. At the minimum, patients should be encouraged to inform the DVLA. This service evaluation aimed to survey the current practice of neurologists and neurosurgeons in the Sheffield Teaching Hospitals Foundation Trust with regards to giving appropriate driving advice to patients with certain neurological conditions as listed by the DVLA.

METHODOLOGY: An anonymous questionnaire on whether driving advice was given was distributed to neurologists and neurosurgeons at consultant and specialist registrar levels over 3 days in January 2013. Conditions surveyed include epilepsy, brain tumour, peripheral neuropathy, Parkinson's disease, Multiple Sclerosis, narcolepsy, dementia, essential tremor, motor neurone disease and myasthenia gravis. All of those conditions were listed in the DVLA notifiable category 1. Participants were required to select one of the four options: always, occasionally, never and not applicable, and to provide their own comments if wanted.

RESULTS: 41 questionnaires were sent out, and 33 responses were collected (response rate 80%). Driving advice on epilepsy was given 'always' in 82% and 'occasionally' in 18%. However, results were varied for other surveyed conditions-brain tumour (always: 48.5%, occasionally: 48.5%, never: 0%, not applicable: 3%), peripheral neuropathy (always: 3%, occasionally: 48.5%, never: 42.4%, not applicable: 6.1%), Parkinson's Disease (always: 42.4%, occasionally: 39.4%, never: 9.1%, not applicable: 9.1%), Multiple Sclerosis (always: 15.1%, occasionally: 60.6%, never: 18.2%, not applicable: 6.1%), narcolepsy (always: 54.4%, occasionally: 15.2%, never: 15.2%, not applicable: 15.2%), dementia (always: 48.5%, occasionally: 48.5%, never: 0%, not applicable: 3%), essential tremor (always: 0%, occasionally: 39.4%, never: 51.5%, not applicable: 9.1%), motor neurone disease (always: 12.1%, occasionally: 39.4%, never: 33.3%, not applicable: 15.2%), and myasthenia gravis (always: 12.1%, occasionally: 36.4%, never: 39.4%, not applicable: 12.1%).

DISCUSSION: This survey demonstrated that the neurologists and neurosurgeons were not consistent in giving driving advice to patients with notifiable neurological conditions. A significant proportion of the sampled population admitted to never giving advice to patients who may not be fit to drive. Possible reasons include the lack of knowledge and limited time available for discussion especially in the outpatient setting. This highlights the urgent need to educate and update clinicians on current DVLA requirements. Recommendations include inviting a DVLA representative to give a talk regarding current driving regulations in the neurosciences academic afternoon and including a tick box for 'Driving advice considered' in the Neurological clerking proforma to prompt clinicians.

5 comments:

  1. It is simple, you notify DVLA if you have a disease listed on the website. You are not insured if you haven't done this. Why waste a Neurologist's time on something that patients should be doing. You fill in the form and DVLA write to your Consultant to make the judgement. Why would anyone want to drive if they were not safe?

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  2. If you fail to tell the DVLA about a medical condition the fine is £1000 and if you are involved in an accident you could be prosecuted. All drivers should know this. It is not a neurological issue. It is the law.

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  3. First of all there is no longer a DVLA website - everything is now on the gov.uk website. Secondly you have to be quite precise in the term used in a search engine to get pointed at the right area of the website. Thirdly, some surprising medical conditions may be notifiable - OCD, high blood pressure, depression, diabetes - the medical professionals presumably have that knowledge so why wouldn't they let their patients know ?

    In my own case, I asked my neurologist when I was diagnosed - I am sure that most people would be too shocked at being given the MS diagnosis to think rationally about notifying the government.

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  4. It isn't about notifying the government, it is about your safety, your family's safety and the rest of the public.

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  5. Perhaps there should be a standard leaflet given to all patients diagnosed providing this and other important info, eg like where to get help, that the ms society exists and who you legally have to tell, your rights as an employee. MS was a big diagnosis for me and i would have liked a 1-page, standardised leaflet that just listed maybe 6 things i needed to know about my new diagnosis, especially how to recognise a relapse and who to call, eg an ambulance?

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