Evidence Based Review of Rehabilitation Interventions for Medically at Risk Older Drivers

Classen, S., Monahan M., Auten, B & Yarney, K.A. (2014). Evidence based review of rehabilitation interventions for medically at risk older drivers. American Journal of Occupational Therapy, 68(4), 107- 114.

The purpose of this study was to conduct an evidence-based review of intervention studies for older drivers with medical conditions. The literature search yielded 128 studies, with a total of 15 intervention studies meeting eligibility criteria. Using the American Occupational Therapy Association’s classification criteria (Levels I–V, Level I – highest level of evidence) based on levels of evidence, reviewers identified driving interventions. To classify the strength of recommendations outlined in each study a letter ranking system was used, ranging from “A” for strongly recommending the intervention to “D” for not recommending the intervention, or “I” classifying a study intervention to be insufficient and not able to make a recommendation. Interventions were recommended for clients with a variety of medical conditions: for clients with stroke, the recommendation was to use of a graded simulator intervention, training in traffic theory, and on-road assessments for clients with visual deficits the recommendation was an education intervention and bioptic training. For clients with dementia, the recommendation was driving restriction. This is the first evidence-based review to provide occupational therapists with an overview of intervention recommendations. For further understanding, additional Level I studies are needed to identify effective interventions for medically at-risk older drivers.