Original research led by Dr Atiyeh Vaezipour contributes to a more comprehensive understanding of the effect of chronic pain on driving behaviour. This research investigates the everyday challenges and barriers experienced by these drivers, as well as drivers’ requirements for ensuring their safety on the roads.
Dr Atiyeh Vaezipour explains the research aims:
“This study is the first of its kind in Australia to seek strategies to improve safe driving among individuals with chronic pain. We have used an innovative driver-centred approach to enhance our understanding of the needs and challenges of Australian drivers experiencing chronic pain.
We used this information to develop evidence-based recommendations and strategies that individuals experiencing chronic pain can use to compensate for difficulties they have when driving.
I hope this research informs decision making among health professionals and enables them to incorporate targeted driving recommendations as a part of their rehabilitation process for individuals experiencing chronic pain.”
Read more about the research here.
Dr Vaezipour worked alongside RECOVER colleagues Dr Nicole Andrews and Associate Professor Venerina Johnston as well as collaborators Professor Mark Horswill (UQ School of Psychology), Dr Oscar Oviedo-Trespalacios (CARRS-Q, QUT) and international collaborator Professor Patricia Delhomme (Univ Gustave Eiffel, Université de Paris).
This research formed part of RACV’s submission to the National Transport Commission (NTC) review into its national Assessing Fitness to Drive guidelines. The guidelines, which are used by state authorities including VicRoads to assess a person’s ability to drive, do not currently address chronic pain.
The full RACV SAFETY Research Fund Report "Driving behaviour in people with chronic pain – perspective of people with chronic pain and health professionals" is available here in downloadable PDF format (PDF, 8.2 MB).
Rationale
Being able to drive is important, and when people stop driving, this can lead to less independence, reduced social integration, lower levels of community participation and poorer quality of life. However, driving is a complex task which requires both the ability to rapidly identify potential hazards and appropriately react to driving situations to avoid crashing. Therefore, attention must be continuously directed towards the road environment as any source of distraction (e.g. talking on a mobile phone, driver pain) could increase the probability of a crash.
Pain could be a source of inattention among drivers, where drivers experiencing pain may present psychological states which could reduce the attentional resources needed for safe driving. In addition, the type and level of pain could impair functional outcomes such as reaction time needed to control the vehicle safely.
Research Methodology
The methodology for this research was guided by a driver-centred design approach, which involves considering the needs, motivations and challenges of the chronic pain drivers at each stage of the research design. These data then inform the development of new intervention and educational resources. A mixed-method design combined both qualitative and quantitative approaches, drawing upon the lived experience of individuals with chronic pain, as well as the knowledge of health professionals as subject matter experts. Figure 1 illustrates an overview of the study design and how it aligns with the research objectives.
Figure 1. Overview of research design
Key recommendations from research
- While people experiencing chronic pain self-regulate their driving, they could benefit from personalised occupational therapy and physiotherapy recommendations on vehicle ergonomics, an ergonomic assessment of their car seating, and educational strategies to reduce pain flare-ups while driving.
- People with chronic pain should review their medications with their GP regularly to reduce the harm or compounding effect as a result of taking multiple medications.
- Family members could be included in open discussions about driving to facilitate problem-solving among the clinician, patient and family member.
- Where possible, if feeling unsafe to drive, supports from family/friends or transport alternatives should be used, e.g. public transport or ridesharing. Road authorities should also continue working towards a more equitable transport system (i.e. accessible public transport, better active travel infrastructure, etc.) to offer viable alternatives to driving.
- Health professionals would benefit from establishing clear and evidence-based guidelines specific for chronic pain, such as Assessing Fitness to Drive as a stand-alone recognised health condition. This could support clinicians with clear recommendations and intervention pathways.
- Health professionals would benefit from training and upskilling to gain confidence to better address medical, physical, emotional and cognitive driving-related concerns in clinic since pain is so subjective and complex.
- Health professionals should take a positive approach to raising awareness among individuals experiencing chronic pain on the factors that potentially impact on driving safety (i.e. medications, physical, cognitive, emotional) and management strategies to address these factors.
This work was made possible by a research grant from the Royal Automobile Club of Victoria (RACV) Safety Research Fund which aims to improve road safety .
“RACV is pleased to support this important research work by the University of Queensland into the relationship between chronic pain and driver behaviour.
“Chronic pain affects one in five Australians, and RACV believes more research is required into the effects of chronic pain on drivers and its impact on driver behaviour. We hope this work improves the lives of people with chronic pain and gives them greater freedom to drive safely. Anything that can ensure the safety of drivers and reduce collisions and our road toll is to be encouraged.” Elvira Lazar, Senior Policy Advisor – Safety, RACV.
