Development of “Fitness to Drive” Assessment – in B.C.

Update: see the previous post – January 11, 2009 Driver’s in Britian to Undergo 10-Year Health Checks

See the story in the Times Colonist.

The British Columbia government is going to roll out a pilot project, which has been developed over the last ten (10) years.  This pilot project will utilize two methods to assist doctors to assess whether senior drivers are fit to continue driving on the roads of B.C.

The B.C. government, in concert with the B.C. Medical Association, has committed to set up a pilot program for the test, possibly in Victoria, said Steve Martin, B.C.’s Superintendent of Motor Vehicles.  Once doctors and government officials have assessed its effectiveness, it will be rolled out across the province.

“I think they will both advance screening for medically at-risk drivers,” said Steve Martin, B.C.’s superintendent of motor vehicles. “It will be a significant change and benefit.”

“This is a new tool that hasn’t been used anywhere in the world yet, so we are very excited about the potential, but we first want to implement it on a limited basis,” Martin said.

SIMARD-MD is an abbreviation for Screen for the Identification of cognitively impaired Medically At-Risk Drivers: a Modification of the DemTect.

The test — called the SIMARD, a Modification of the DemTect — takes about five minutes to complete in a doctor’s office and evaluates four abilities needed for driving: memory, attention, judgment and decision-making. To avoid skewing results, specifics about what’s on the test are only being made available to doctors.

To help doctors make that assessment, a new 29-chapter guide, developed by the Office of the Superintendent of Motor Vehicles with the BCMA, will be available to B.C. doctors at the end of June.

One tool is a simple pen-and-paper test to identify whether drivers with a cognitive impairment or dementia are safe to drive. The other tool is B.C.’s new medical-fitness driver guidelines which define for doctors how certain medical conditions can adversely affect driving.

The pen-and-paper test was developed by two University of Alberta researchers — Bonnie Dobbs, director of the Medically At-Risk Driver Centre and associate professor in family medicine, and Don Schopflocher, an associate professor and research statistician.

Finding a new screening tool to detect which drivers shouldn’t be on the road or should go for a road test was a quest that piqued the interest of both Dobbs and Holly Tuokko, director of the Centre on Aging at the University of Victoria, more than 10 years ago.

Tuokko became involved with CANDRIVE, the Canadian Driving Research Initiative for Vehicular Safety in the Elderly, a federally funded five-year study, now in its second year, that is working to create a better medical checklist and road tests geared to seniors.

In an earlier test called DemTect, developed by Germany’s Dr. Elke Kalbe and his colleagues, proved to be especially useful. It is a screening test used to assist doctors in diagnosing patients with mild cognitive impairment and early dementia.The SIMARD-MD determines the probability of a pass or fail on a road test with physicians are well situated to identify medically at-risk drivers,” Dobbs said. “But the lack of valid tools has hampered their ability to determine with greater accuracy which of their patients with cognitive impairment may be at risk for declines in driving competency and which ones are safe to continue driving,” Dobbs said.

The SIMARD-MD determines the probability of a pass or fail on a road test with testing shows that many older drivers take longer to perform motor activities. Weaker muscles, reduced flexibility and range of motion and conditions such as arthritis make it more difficult to:

Testing shows that many older drivers take longer to perform motor activities. Weaker muscles, reduced flexibility and range of motion and conditions such as arthritis make it more difficult to:

– turn one’s head

– grip and turn the steering wheel

– press the accelerator or brake

– reach the controls or open windows and doors

In 2025, one in four Canadians will be 65 or older. And according to the Alzheimer Society of Canada, by 2040 the number of people with Alzheimer’s disease in Canada will more than double. Alzheimer’s disease is the most common form of dementia.

The SIMARD-MD can show the probability of a pass or fail on a road test with all kinds of medical conditions can impair driving but there are broad areas of concern. Those include conditions that affect: vision such as glaucoma, motor control such as arthritis or Parkinson’s, mental functions such as seizures or infections, and progressive neuro-degenerative disorders that affect the brain’s ability to process and retain information.

The research behind B.C.’s guidelines followed a number of human rights rulings that said it’s not acceptable to discriminate against classes of drivers based solely on things such as age or medical conditions.

In B.C., the motor vehicle branch makes the ultimate decision on whether to yank a driver’s licence

It’s no longer acceptable to prevent someone from driving because of their age or the name of their medical condition, said Martin. Instead, today’s drivers are being judged by their ability to drive.

B.C. is the only province with its own medical fitness driver guidelines.

Under the new B.C. Motor Vehicle Amendment Act passed last month, psychologists, optometrists, medical practitioners, nurse practitioners and occupational therapists are required to report any patient, who may be unfit to operate a vehicle because of a medical condition. This is what was passed under the Motor Vehicle Amendment Act:

BILL 14 — 2010

MOTOR VEHICLE AMENDMENT ACT, 2010

21 Section 230 is repealed and the following substituted:

Report of medical condition or impairment

230  (1) This section applies to psychologists, optometrists, medical practitioners, nurse practitioners and occupational therapists.

(2) A person referred to in subsection (1) who has a patient 16 years of age or older

(a) who, in the opinion of the person, has a medical condition or functional impairment set out in the regulations, must report to the superintendent

(i) the name, address and medical condition or functional impairment of the patient,

(ii) the name and business contact information of the person, and

(iii) other information the person believes is relevant to the fitness and ability of the patient to drive a motor vehicle, or

(b) who, in the opinion of the person, has a medical condition or functional impairment that can reasonably be expected to affect the fitness and ability of the patient to drive a motor vehicle, may make a report referred to in paragraph (a).

(3) Subsection (2) (a) does not apply in circumstances set out in the regulations.

(4) Subject to subsection (5), no legal proceeding for damages lies or may be commenced or maintained against a psychologist, an optometrist, a medical practitioner, a nurse practitioner or an occupational therapist because of anything done or omitted

(a) in the performance or intended performance of a duty referred to in subsection (2), or

(b) in the exercise or intended exercise of a power referred to in subsection (2).

(5) Subsection (4) does not apply to a person referred to in that subsection in relation to anything done or omitted by that person in bad faith.

(6) The Lieutenant Governor in Council may make regulations as follows:

(a) setting out medical conditions or functional impairments that oblige a person referred to in subsection (1) to report;

(b) setting out circumstances when the duty to report does not apply.

It's only fair to share...
Share on FacebookTweet about this on TwitterGoogle+Pin on Pinterestshare on TumblrShare on LinkedInShare on RedditEmail to someone

Leave a Reply

Your email address will not be published.