Evidence map›Paper›PMID 39382896›Full record

ArticleJAMA network open2024

Medication Changes Among Older Drivers Involved in Motor Vehicle Crashes.

Andrew R Zullo, Melissa R Riester, Adam M D'Amico, Monika Reddy Bhuma, Marzan A Khan, Allison E Curry, Melissa R Pfeiffer, Seth A Margolis, Brian R Ott, Thomas Bayer and 1 more

Erratum issuedAbstract read
In one paragraph

Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Andrew R ZulloDepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.
Melissa R RiesterDepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.
Adam M D'AmicoDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
Monika Reddy BhumaDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
Marzan A KhanDepartment of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
Allison E CurryCenter for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Melissa R PfeifferCenter for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Seth A MargolisRhode Island Hospital, Providence.
Brian R OttDepartment of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island.
Thomas BayerCenter of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, Rhode Island.
Nina R JoyceDepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.

Funding

Clinically Significant Drug Interactions among Nursing Home Residents with ADRDR01AG077620 · NIA · BROWN UNIVERSITY · PI Andrew Reis Zullo · 2022 to 2026
$3.5M
The risks and consequences of a motor vehicle crash in older adults with Alzheimer's Disease and Related DementiasR01AG079295 · NIA · BROWN UNIVERSITY · PI JOYCE, NINA · 2022 to 2025
$3.0M
Medications and the Risk of Motor Vehicle Crashes in Older AdultsR01AG065722 · NIA · BROWN UNIVERSITY · PI ZULLO, ANDREW REIS · 2020 to 2023
$2.1M
NIA NIH HHS R01 AG065722NIA NIH HHS R01 AG077620NIA NIH HHS R01 AG079295
6 · The paper itself

Abstract

Importance: Although older adults may use potentially driver-impairing (PDI) medications that can produce psychomotor impairment, little is known about changes to PDI medication use among older adults from the time before to the time after a motor vehicle crash (MVC). Objective: To quantify use of and changes in PDI medications among older adults before and after an MVC. Design, Setting, and Participants: This cohort study used linked Medicare claims and police-reported MVC data on 154 096 person-crashes among 121 846 older drivers. Eligible persons were drivers aged 66 years or older, involved in a police-reported MVC in New Jersey from May 1, 2007, through December 31, 2017, and with continuous enrollment in Medicare fee-for-service Parts A and B for at least 12 months and Part D for at least 120 days prior to the MVC. Data were analyzed from January 2022 to May 2024. Main Outcomes and Measures: Use of benzodiazepines, nonbenzodiazepine hypnotics, opioid analgesics, and other PDI medications in the 120 days before and 120 days after the MVC. Because each person could contribute multiple MVCs during the study period if they met eligibility criteria, the unit of analysis was the number of person-crashes. The proportion of person-crashes after which PDI medications were started, discontinued, or continued was quantified as well. Results: Among 154 096 eligible person-crashes, the mean (SD) age of the drivers was 75.2 (6.7) years at the time of the MVC. Of 121 846 unique persons, 51.6% were women. In 80.0% of the person-crashes, drivers used 1 or more PDI medications before the crash, and in 81.0% of the person-crashes, drivers used 1 or more PDI medications after the crash. Use of benzodiazepines (8.1% before the crash and 8.8% after the crash), nonbenzodiazepine hypnotics (5.9% before the crash and 6.0% after the crash), and opioid analgesics (15.4% before the crash and 17.5% after the crash) was slightly higher after the MVC. After the MVC, drivers in 2.1% of person-crashes started benzodiazepines and 1.4% stopped benzodiazepines, drivers in 1.2% of person-crashes started nonbenzodiazepine hypnotics and 1.2% stopped nonbenzodiazepine hypnotics, and drivers in 8.4% of person-crashes started opioid analgesics and 6.3% stopped opioid analgesics. Conclusions and Relevance: This cohort study suggests that most older drivers involved in MVCs did not use fewer PDI medications after crashes than before crashes. Qualitative research of perceived risks vs benefits of PDI medications is necessary to understand the reasons why MVCs do not appear to motivate clinicians to deprescribe PDI medications as a strategy to avert potential harms, including additional MVCs.

Indexed as

Accidents, TrafficAgedAged, 80 and overAnalgesics, OpioidAutomobile DrivingBenzodiazepinesCohort StudiesFemaleHumansHypnotics and SedativesMaleMedicareNew JerseyUnited StatesAnalgesics, OpioidBenzodiazepinesHypnotics and Sedatives

Identifiers

PMID39382896
PMCPMC11581636

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.