Ludivine Orriols1,2, Audrey Luxcey1,2, Benjamin Contrand1,2, Blandine Gadegbeku3,4,5, Bernard Delorme6, Aurore Tricotel7, Nicholas Moore8, Louis-Rachid Salmi1,2,9, Emmanuel Lagarde1,2. 1. Centre INSERM U1219-Epidemiologie-Biostatistique, Université de Bordeaux, ISPED, F-33000, Bordeaux, France. 2. INSERM, IETO team, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000, Bordeaux, France. 3. Université de Lyon, F-69000, Lyon, France. 4. IFSTTAR, UMR T 9405, UMRESTTE, F-69500, Bron, France. 5. UMRESTTE, Université Lyon 1, F-69000, Lyon, France. 6. External expert of the French National Agency for Medicines and Health Products Safety (ANSM), France. 7. Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM), 93385, Saint-Denis Cedex, France. 8. INSERM U1219, Université de Bordeaux, CIC1410, Bordeaux, France. 9. Service d'information médicale, CHU de Bordeaux, Pôle de santé publique, Bordeaux, France.
Abstract
AIMS: To assess potential change in medicine exposure and association with the risk of road traffic crash across a time period that started before the implementation of a grading system warning of the effect of medicine on driving performance. METHODS: Data from three French national databases were extracted and matched: the national health care insurance database, police reports and the national police database of injurious crashes. Drivers involved in such crashes in France, from July 2005 to December 2011 and identified by their national identifier, were included. Association with the risk of crash was estimated using a case-control analysis comparing benzodiazepine and z-hypnotic use among drivers responsible or not responsible for the crash. RESULTS: Totals of 69 353 responsible and 73 410 non-responsible drivers involved in an injurious crash were included. Exposure to benzodiazepine anxiolytics was associated with an increased risk of being responsible for a road traffic crash during the pre-intervention period (OR = 1.42 [1.24-1.62]). The association disappeared in the post-intervention period, but became significant again thereafter. The risk of being responsible for a crash increased in users of z-hypnotics across the study period. CONCLUSIONS: Our results question the efficacy of the measures implemented to promote awareness about the effects of medicines on driving abilities. Prevention policies relating to the general driving population, but also to healthcare professionals, should be reviewed.
AIMS: To assess potential change in medicine exposure and association with the risk of road traffic crash across a time period that started before the implementation of a grading system warning of the effect of medicine on driving performance. METHODS: Data from three French national databases were extracted and matched: the national health care insurance database, police reports and the national police database of injurious crashes. Drivers involved in such crashes in France, from July 2005 to December 2011 and identified by their national identifier, were included. Association with the risk of crash was estimated using a case-control analysis comparing benzodiazepine and z-hypnotic use among drivers responsible or not responsible for the crash. RESULTS: Totals of 69 353 responsible and 73 410 non-responsible drivers involved in an injurious crash were included. Exposure to benzodiazepine anxiolytics was associated with an increased risk of being responsible for a road traffic crash during the pre-intervention period (OR = 1.42 [1.24-1.62]). The association disappeared in the post-intervention period, but became significant again thereafter. The risk of being responsible for a crash increased in users of z-hypnotics across the study period. CONCLUSIONS: Our results question the efficacy of the measures implemented to promote awareness about the effects of medicines on driving abilities. Prevention policies relating to the general driving population, but also to healthcare professionals, should be reviewed.
Authors: Silvia Ravera; Nienke van Rein; Johan J de Gier; Lolkje T W de Jong-van den Berg Journal: Br J Clin Pharmacol Date: 2011-09 Impact factor: 4.335
Authors: Susana P Monteiro; René Huiskes; Liset Van Dijk; Julia C M Van Weert; Johan J De Gier Journal: Traffic Inj Prev Date: 2013 Impact factor: 1.491
Authors: L Orriols; P Philip; N Moore; A Castot; B Gadegbeku; B Delorme; M Mallaret; E Lagarde Journal: Clin Pharmacol Ther Date: 2011-03-02 Impact factor: 6.875
Authors: Silvia Ravera; Susana P Monteiro; Johan Jacob de Gier; Trudy van der Linden; Trinidad Gómez-Talegón; F Javier Alvarez Journal: Br J Clin Pharmacol Date: 2012-12 Impact factor: 4.335