Driving Problems in Patients with Rheumatoid Arthritis

ANN B. CRANNEY, ADAM HARRISON, LUCIA RUHLAND, CHANTAL VAIDYANATH, IAN GRAHAM, MALCOLM MAN-SON-HING, JAMES JAFFEY, TANVEER E. TOWHEED, TASSOS P. ANASTASSIADES, and ISAAC I. DWOSH

ABSTRACT.

Objective. To assess driving problems experienced by patients with rheumatoid arthritis (RA) and to examine the relationship between functional status and driving difficulty.

Methods. Using the South Eastern Ontario Medical Organization (SEAMO) database, we identified 721 patients with RA from both urban and rural backgrounds. They completed a cross-sectional, self-administered mail survey that included the Health Assessment Questionnaire (HAQ-DI) and a co-morbidity questionnaire. We assessed the proportion of drivers versus non-drivers and patients who reported difficulty driving and who used vehicle adaptations.

Results. Survey response rate was 74% and 92.2% of the subjects were current drivers. Fifty percent of the current drivers reported a little difficulty, 6.8% reported quite a bit of difficulty, and 1.5% a great deal of difficulty driving. Major reasons given for why RA limited their driving were stiffness and pain. Frequent use of mobility aids (adjusted odds ratio, OR: 5.85), HAQ-DI ≥ 1 (adjusted OR: 3.40), and older age (adjusted OR: 1.04) were significant predictors of an individual with RA discontinuing driving. Higher levels of disability (HAQ-DI) were associated with a greater number of problems reported with driving and with curtailment of driving. A multivariate logistic regression determined that having a HAQ-DI ≥ 1 (adjusted OR: 4.3) and difficulties sitting in the vehicle (adjusted OR: 2.9) were associated with RA limiting driving.

Conclusion. Over 50% of respondents reported some degree of difficulty driving due to their RA. Scores on HAQ-DI ≥ 1 were associated with difficulty driving. Further validation of our findings needs to be performed. (J Rheumatol 2005;32:2337-42)

Key Indexing Terms:

DRIVING
RHEUMATOID ARTHRITIS
VEHICLE ADAPTATIONS
HEALTH ASSESSMENT QUESTIONNAIRE

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From the Ottawa Health Research Institute, Ottawa and the Department of Medicine, Queen's University, Kingston, Ontario, Canada.

Supported by a grant from the Department of Medicine, Queen's University.

A. Cranney, MD, MSc, Associate Professor, Department of Medicine, Ottawa Health Research Institute; A. Harrison, Summer Student, Clinical Epidemiology Program, Ottawa Health Research Institute; L. Ruhland, MSc, Research Associate, Queen's University; C. Vaidyanath, MD, Fellow in Rehabilitation Medicine, Queen's University; I.D. Graham, PhD, Associate Professor, School of Nursing, Senior Scientist, Ottawa Health Research Institute; M. Man-Son-Hing, MD, MSc, Associate Professor, Department of Medicine, Ottawa Health Research Institute; J. Jaffey, MSc, Statistician, Ottawa Health Research Institute; T. Towheed, MD, MSc, Associate Professor, Department of Medicine and Community Health and Epidemiology; T.P. Anastassiades, MD, PhD, Professor, Department of Medicine; I.L. Dwosh, MD, Professor, Department of Medicine, Queen's University.

Address reprint requests to Dr. A. Cranney, C402, Ottawa Hospital, Civic Campus, Clinical Epidemiology Program, Ottawa Health Research Institute, 1053 Carling Ave, Ottawa, Ontario, K1Y 4E9. E-mail: ancranney@ohri.ca

Accepted for publication July 18, 2005.

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