Introduction. Most Australians are dependent on their cars for mobility, thus relinquishing driving licences for medical reasons poses challenges. Aims. To investigate how general practitioners (GPs) recognise and manage patients’ fitness to drive, GPs’ attitudes and beliefs about their role as assessors, and GPs’ experiences in assessing and reporting to driving authorities and identify GPs’ educational needs. Methods. Mixed methods: questionnaire mailed to GPs from three rural and two metropolitan Divisons of General Practice in Victoria, Australia. Results. 217/1028 completed questionnaires were returned: 85% recognised a patients’ fitness to drive, 54% felt confident in their assessment ability, 21% felt the GP should have primary responsibility for declaring patients’ fitness to drive, 79% felt that reporting a patient would negatively impact on the doctor-patient relationship, 74% expressed concern about legal liability, and 74% favoured further education. Discussion. This study provides considerable information including recommendations about GP education, the assessment forms, and legal clarification. 1. Introduction Australians are reliant on driving as it allows people to maintain their independence and independence is a key component of positive ageing [1]. Public transport is often inaccessible or unavailable [2], particularly in rural areas. Where and when public transport is available, older people and those with disabilities can experience problems getting on and off public transport or walking to and from stops [1, 2] and can be at greater risk of being killed as pedestrians than are other age groups [2–5]. Regardless of age, cognitive impairment has consistently been shown to increase the risk of crashing [6, 7]. Other factors which affect driving ability include visual defects such as constriction of binocular field, decreased grip, muscle strength and endurance, flexibility and motor speed, decreased neck rotation, arthritis, neurological impairment and falls [6, 8], insulin-dependent diabetes mellitus, and epilepsy [9]. There are increasing numbers of drivers who continue to drive in later life [5, 10, 11]. Given an ageing population and increased morbidity, there will be a greater proportion who have a diminished capacity for driving, with the number of fatalities involving older drivers being estimated to almost triple by 2025 [10]. This prediction is based on a widespread perception that older people are at increased risk of car accidents [11–13]. Calculating the number of crashes per licensed driver and particularly for older
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