ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1259

Driving Performance and Safety in Rheumatoid Arthritis: A Systematic Review

Daniel Zhou1, Ted R. Mikuls2, Cynthia Schmidt3, Bryant R. England4, Debra A Bergman5, Matthew Rizzo6, Jennifer Merickel6 and Kaleb Michaud7,8, 1Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 2Internal Medicine, Division of Rheumatology, VA Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, NE, 3McGoogan Library of Medicine, University of Nebraska Medical Center, Omaha, NE, 4Rheumatology, VA Nebraska-Western Iowa Health Care System & University of Nebraska Medical Center, Omaha, NE, 5Division of Rheumatology, VA Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha, NE, 6Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, 7Rheumatology, University of Nebraska Medical Center, Omaha, NE, 8FORWARD, The National Databank for Rheumatic Diseases, Wichita, KS

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Date: Monday, October 22, 2018

Title: Measures and Measurement of Healthcare Quality Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Automobile driving represents an instrumental activity of daily living (IADL). Symptoms accompanying RA, including fatigue, joint pain and stiffness, decreased strength, reduced mobility, and poor sleep quality, have the potential to adversely impact driving ability. In this systematic review, we aimed to identify whether RA is associated with driving performance and/or the use of assistive devices or modifications to improve driving performance.

Methods:   We conducted a systematic literature review following PRISMA guidelines of RA and driving performance/modifications by searching CINAHL, Cochrane library, EMBASE, MEDLINE, PREMEDLINE, PsycINFO, Google Scholar, and Scopus databases from inception to April 2018. We excluded studies that were not in English, had no original or quantitative data, included <5 RA patients, or did not report specifically on RA.

Results: Our search yielded 1935 potential manuscripts, of which 22 fulfilled eligibility criteria. Most studies were cross-sectional (n=14). Studies reporting the prevalence of driving factors among persons with RA are summarized in the Table. Based on weighted means, of total RA patients studied 13% were involved in motor vehicle crashes (MVCs), 26% experienced difficulties with driving, 34% leveraged assistance or modifications to drive, and 26% were unable to drive. In at least one study, RA patients were involved in fewer MVCs than their age-matched controls (23% vs. 35%) [Maki et al., 1976]. A separate investigation employing an independent driving assessment determined that 19% (n=37) of RA patients were not fit to drive [Jones et al., 1991].

Conclusion:   There is a scarcity of data that quantitatively relates RA to driving performance and or related safety outcomes. Recognizing significant variability among individual reports, available data suggests that driving difficulties and the subsequent use of modifications are prevalent in those with RA. Given its importance as an IADL, further investigation of driving performance and potential driving modifications are needed.

 

Outcome Examined / References

No. of RA pts.

Frequency with End Point, %

 

Outcome Examined / References

No. of RA pts.

Frequency with End Point, %

Experiencing MVC

 

Inability to Drive

Cranney, 2005

520

7.7

 

Cranney, 2005

520

7.7

Koepsell, 1994

11

45.5

 

Dawson, 1995

50

50.0

Maki, 1976

208

23.1

 

Ekdahl, 1989

26

7.7

Weighted Mean Frequency

13.1

 

Katz, 2008

547

1.1

 

 

 

 

Wollenhaupt, 2013

276

7.2

Reporting Driving Difficulty

 

Weighted Mean Frequency

26.3

Ewert, 2004

37

51.4

 

 

 

 

Katz, 2008

547

27.1

 

Difficulty Commuting

Nordenskiöld, 1998

21

76.2

 

Ahlstrand, 2015

737

80.3

Thyberg, 2005

276

15.2

 

Allaire, 1996

469

10.9

Thyberg, 2004

169

17.2

 

Allaire, 2009

953

4.0

Wollenhaupt, 2013

256

33.6

 

Weighted Mean Frequency

31.5

Weighted Mean Frequency

26.0

 

 

 

 

 

 

 

 

Reduced Transport Mobility

Use of Driving Assistance

 

Albers, 1999

186

52.2

Busteed, 2004

30

26.7

 

Chorus, 2001

720

10.0

Dawson, 1995

25

36.0

 

Weighted Mean Frequency

18.7

Katz, 2007

458

37.8

 

 

 

 

Lapsley, 2002

81

14.8

 

 

 

 

Weighted Mean Frequency

34.0

 

 

 

 

 

Disclosure: D. Zhou, None; T. R. Mikuls, BMS, Ironwood, Horizon, 2,Pfizer, Inc., 5; C. Schmidt, None; B. R. England, None; D. A. Bergman, None; M. Rizzo, None; J. Merickel, None; K. Michaud, None.

To cite this abstract in AMA style:

Zhou D, Mikuls TR, Schmidt C, England BR, Bergman DA, Rizzo M, Merickel J, Michaud K. Driving Performance and Safety in Rheumatoid Arthritis: A Systematic Review [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/driving-performance-and-safety-in-rheumatoid-arthritis-a-systematic-review/. Accessed .

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