Prescribed anti‐glaucoma medication consumption and road traffic crash

Lu, Li; Contrand, Benjamin; Schweitzer, Cedric; Gadegbeku, Blandine; Delcourt, Cécile; Lagarde, Emmanuel · 2023 · Crossref

DOI: 10.1002/pds.5577

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Summary

This study investigates the association between prescribed anti-glaucoma medication consumption and road traffic crash risk, as well as crash responsibility among drivers. Glaucoma is a leading cause of visual impairment, and concerns exist regarding how associated visual defects and medication side effects might impact driving safety. The research aimed to determine if anti-glaucoma drug use increases the likelihood of crash involvement or being deemed responsible for a crash, addressing conflicting evidence from previous simulation and real-world studies. The researchers utilized data from three French national databases: police reports, the national police database of injurious crashes, and the national health care insurance database. The study period spanned from July 1, 2005, to December 31, 2015. The case group consisted of 201,497 drivers involved in injurious road crashes. An age- and sex-matched control group of 113,357 individuals was randomly drawn from the general population. Exposure to anti-glaucoma medications was identified using prescription records from the health care insurance database, categorized by the Anatomical Therapeutic Chemical classification system. Crash responsibility was determined using a standardized scoring method based on mitigating factors such as road conditions and traffic rule obedience. Logistic regression models were employed to compare medication use between crash-involved drivers and controls, and between responsible and non-responsible drivers, adjusting for covariates including age, sex, chronic conditions, occupation, vehicle type, blood alcohol concentration, and injury severity. The results indicated that the proportion of drivers with prescribed anti-glaucoma medicine increased markedly with age. Crucially, the use of one type (OR=0.79, 95% CI: 0.72-0.86) or two or more types (OR=0.82, 95% CI: 0.68-0.98) of anti-glaucoma medication was less frequent in crash-involved drivers compared to the control group, suggesting a negative association with crash risk. Furthermore, among drivers already involved in crashes, there was no significant association between anti-glaucoma medication use and crash responsibility. The odds ratios for one type (OR=0.99, 95% CI: 0.88-1.12) and two or more types (OR=1.04, 95% CI: 0.82-1.33) of medication use showed no link to being deemed responsible for the accident. The findings suggest that prescribed anti-glaucoma medication consumption is not a risk factor for road traffic crashes and may even be associated with a lower likelihood of involvement. The authors conclude that these results are reassuring regarding existing guidelines for safe driving for individuals using these medications. They propose that the negative association may reflect effective driving behavior adaptation, such as self-regulation and restriction of driving in challenging situations, which mitigates potential risks. Additionally, the medication may help prevent disease progression to severe stages that could impair driving. The study highlights the importance of self-regulatory practices among glaucoma patients to maintain driving safety.

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• prescription meds