Abstracts

Driving restrictions play a central role in the quality of life in patients with epilepsy (PWE). Neurologists as well as other physician groups bear considerable responsibility for decisions about driving privileges in PWE. However, little is known about how neurologist[apos]s attitudes compare to other physician groups. The purpose of this survey was to compare practices and beliefs across physician subspecialties that treat PWE. A sample of 209 physicians (Neurologists = 56; non-neurologists (NN) = Family Practice and Internal Medicine physicians = 133 and Other/unspecified = 20) completed a 28-item survey related to driving issues and epilepsy. Surveys were completed through fax technology that met IRB approval. A random geographic sampling of 1400 physicians, obtained through a commercial provider, were faxed the survey. A 19% response rate was achieved. Some neurologists completed the survey during a regional epilepsy conference (21 of 48 conference attendees). All practitioners treated PWE and nearly 100% of those surveyed felt driving should be allowed with seizure control. Both groups felt that 6 months seizure-free was an appropriate limit for reinstatement of driving privileges. NNs were more likely to oppose allowing people with uncontrolled seizures to drive (99% vs. 92%; p [lt] .01). NNs were more likely to oppose people with uncontrolled seizures having driver[apos]s licenses when the seizures did not result in the loss of consciousness (85% vs. 61%; p [lt] .001), when seizures occurred nocturnally (72% vs. 45%; p [lt] .001), and more likely to agree that states should set a minimum time for PWE to be seizure free before allowing a driver[apos]s license (96% vs. 80%; p [lt] .005). NNs were more likely to support mandatory reporting of patient seizure information to state motor vehicle departments (90% vs. 36%; p [lt] .001). Neurologists were more likely to have had PWE report an automobile accident due to a seizure, (72% vs. 33%; p [lt] .001), more likely to have suspected that PWEs had an unreported automobile accident due to a seizure (60% vs. 39%; p [lt] .01), and to have had PWE give justifications for having to drive (75% vs. 58%; p [lt] .05). Neurologists and NNs expressed several similar opinions regarding the importance of physician assistance in evaluating driving issues in PWE and the need for driving restrictions under certain circumstances. However, they differed in terms of specific areas including mandatory reporting and obtaining a drivers license under certain conditions. Although neurologists have had more patients involved in automobile accidents, NNs were generally more restrictive in their support for driving by PWE. This survey highlights the need for continued epilepsy-specific education outreach efforts directed at the non-neurology medical community. (Supported by the Special Interest Project from the Centers for Disease Control and Prevention awarded through the UAB Center for Health Promotion.)