GPs' awareness of car driving among oldest patients - exploratory results from a primary care cohort.

BACKGROUND Increasingly more very old people are active drivers. Sensory, motor and cognitive limitations or medication can increase safety risks. Timely attention to driving safety in the patient-doctor relationship can promote patient-centred solutions. AIM Do general practitioners (GPs) know which patients drive a car? Is fitness to drive addressed with patients? DESIGN & SETTING Cross-sectional data from patient interviews and GP survey in the ninth follow-up phase of the German AgeCoDe/AgeQualiDe prospective primary care cohort study. METHOD Sample: Patients in the age group 85+ and their GPs; independent reports on driving activity from GP and patient; information from GPs on whether driving ability was discussed with the patient; validity parameters, bivariate characterisation of subgroups (non-parametric significance tests, effect size) RESULTS: Self-reports of 553 patients are available (69.5% female; mean age 90.5 years; 15.9% drive a car), for 427 patients GP data are also available: GPs recognise 67.1% correctly as drivers and 94.9% as non-drivers. GPs say that they have discussed fitness to drive with 32.1% of potentially driving patients. Among drivers who are not recognised and with whom driving has not been discussed, there are more patients with a low educational level. CONCLUSION The GP's assessment of driving activity among very old patients shows moderate sensitivity and good specificity. Driving ability is discussed seldom. An appropriate question could increase GPs' awareness of older patients' automobility.