Sherrilene Classen, Miriam Monahan, Beth Auten, Abraham Yarney; Evidence-Based Review of Interventions for Medically At-Risk Older Drivers. Am J Occup Ther 2014;68(4):e107–e114. https://doi.org/10.5014/ajot.2014.010975
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© 2020 American Occupational Therapy Association
OBJECTIVE. To conduct an evidence-based review of intervention studies of older drivers with medical conditions.
METHOD. We used the American Occupational Therapy Association’s classification criteria (Levels I–V, I = highest level of evidence) to identify driving interventions. We classified studies using letters to represent the strength of recommendations: A = strongly recommend the intervention; B = recommend intervention is provided routinely; C = weak evidence that the intervention can improve outcomes; D = recommend not to provide the intervention; I = insufficient evidence to recommend for or against the intervention.
RESULTS. For clients with stroke, we recommend a graded simulator intervention (A) and multimodal training in traffic theory knowledge and on-road interventions (B); we make no recommendation for or against Dynavision, Useful Field of View, or visual–perceptual interventions (I). For clients with visual deficits, we recommend educational intervention (A) and bioptic training (B); we make no recommendation for or against prism lenses (I). For clients with dementia, we recommend driving restriction interventions (C) and make no recommendation for or against use of compensatory driving strategies (I).
CONCLUSION. Level I studies are needed to identify effective interventions for medically at-risk older drivers.
Published from January 1, 1997, to January 31, 2013, because rehabilitation intervention studies for medically at-risk drivers emerged during the past 16 yr
Located from searches in databases indexing systematic reviews, psychological and social science, medicine, and health science (i.e., Cochrane Library, PsycINFO, Age Line, PubMed, CINAHL, Sociological Abstracts, Web of Science) and from experts in the field
Published in the English language literature
Contained key word–controlled vocabulary terms (MeSH, etc.) or were retrieved from “footnote chasing” (i.e., finding additional citations in the reference list of selected articles)
Addressed outcomes of a comprehensive driving evaluation, which uses evidence-based clinical tests and an on-road assessment administered by an occupational therapist (or medically trained) CDRS
Had outcomes of driving simulation, crashes, citations or violations, and self-report.
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