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June 4, 2012
Ontario doctors are legally required to report patients they consider medically unfit to drive to the Ministry of Transportation (MTO) – yet they may not be doing it. A new study from Lawson Health Research Institute shows doctors treating patients with brain cancer are unclear about how and when to assess and report a patient’s ability to drive.
Brain tumours can compromise a patient’s ability to safely operate a motor vehicle. The Canadian Medical Association has drafted guidelines to help physicians assess these risks. But according to Dr. Alex Louie, a Scientist at Lawson, 76% of Southwestern Ontario physicians caring for patients with brain cancer feel reporting guidelines are unclear.
In a recent survey led by Dr. Louie, only three quarters of doctors in this group said they consider reporting brain tumour patients at all. When they do consider reporting, it is usually motivated by legal obligations – even though almost a quarter of the respondents could not clearly define these laws and how they are impacted by them.
In a review of actual clinical practice, Dr. Louie’s group looked at the driving assessments for patients receiving brain radiotherapy at London Health Sciences Centre’s (LHSC) London Regional Cancer Program (LRCP) between January and June 2009. Results show only 41% of patients were advised not to drive, and only 30% were reported to MTO. Of the patients who experienced seizures – automatic grounds for revoking a license – only 68% discussed driving with their doctor, and only 56% were reported to the licensing authority.
Research from other countries, and in other medical conditions like heart disease and diabetes, suggests inconsistent assessment and reporting are widespread concerns. Further research is required to determine the extent of the issue and to provide an appropriate solution.
"Our overarching goal is to make Canadians aware that this is an issue," Dr. Louie says. "We need more clear and precise guidelines, and more education of physicians, to protect both the safety of our patients and our society."
Dr. Louie presented the results of this study last night at the Novartis Oncology Young Canadian Investigator Awards (NOYCIA) Dinner in Chicago, where he was honored for the second year in a row.
Dr. Louie is a Scientist at Lawson, and the Chief Resident in Radiation Oncology at LHSC’s LRCP and Western University, working under Dr. David D’Souza. Other collaborators on the study include Esther Chan and Michelle Hanna, both 3rd year medical students at Western University’s Schulich School of Medicine & Dentistry, and Drs. David Palma and George Rodrigues.