Abstracts

Rationale: In the USA, different states have varying rules regarding mandatory reporting and counseling patients with recurrent events of loss of consciousness (LOC)and epilepsy. In six of the fifty states, including New Jersey, it is mandatory on the part of managing physicians to report these patients to the state Department of Motor Vehicles(DMV). Epilepsy is actually a rare cause of car crashes and accounts for approximately 0.2% of fatalities (Richards, K. Neurology 2004;63;E12). Other medical causes including diabetes, cardiovascular events, hypertensive disorders, asthma, and alcoholism have been found to be the more common causes of fatal car crashes. This survey evaluates the knowledge of New Jersey(NJ)non-neurologist physicians (NNPs)reporting patterns in this mandatory reporting state. Methods: This IRB approved pilot survey was undertaken to evaluate the knowledge of practicing NNPs in NJ of DMV rules and regulations for patients with serial events of LOC. We asked whether the NNPs were aware that NJ is a mandatory reporting state and if they have followed these mandates (reporting patients to the state). Physicians and physician assistants at two tertiary care hospitals in central New Jersey anonymously completed a six question survey. Questions asked included the number of years practiced in NJ, whether they treat patients with recurrent events of impaired consciousness, knowledge that NJ is a mandatory reporting state and their reporting practices. Results: Seventy one NNPs were surveyed all of whom practiced an average of 13 years (range 1-40 yrs). NNPs included the following: cardiologists, ED physicians, family physicians, internists, pulmonary specialists, and endocrinologists. 75% of NNPs had patients with two or more events of LOC in a year. 38% of NNPs knew that NJ was a mandatory reporting state. 32.4% knew that patients with recurrent events of LOC need freedom from LOC events for one year before driving privilege reinstatement. Only 22.2% of these NNPs ever reported their patients to the DMV. Conclusions: Though epilepsy is a rare cause of fatal and nonfatal car crashes, other medical causes are more common. Only about one third of NNPs surveyed knew that NJ is a mandatory reporting state. Of the NNPs who saw patients with recurrent periods of impaired consciousness, a mere 22.2% reported these patients to the state DMV. A recent study found neurologists reporting in NJ to be 35% (Drazkowski et al. AES Abst. 1.130, 2009). With such low reporting rates and so few NNPs knowing these laws in general, it calls into question the utility of these mandatory reporting statutes and their effectiveness. In addition, the fact that these laws are not uniform from state to state may also further complicate matters. NJ DMV rules and regulations are more stringent and seem ignored by many NNPs and neurologists. Educating NNPs and neurologists regarding the state laws and increased patient counseling of the risks of impaired driving may indeed help improve public safety.