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 |
|
|
|
|
|
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 .ACR Meeting Abstracts - https://acrabstracts.org/abstract/driving-performance-and-safety-in-rheumatoid-arthritis-a-systematic-review/