Psychoactive Medications and Crash Involvement Requiring Hospitalization for Older Drivers: A Population‐Based Study

<jats:p> <jats:bold>OBJECTIVES: </jats:bold> To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.</jats:p><jats:p> <jats:bold>DESIGN: </jats:bold> Retrospective population‐based case‐crossover study.</jats:p><jats:p> <jats:bold>SETTING: </jats:bold> A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.</jats:p><jats:p> <jats:bold>PARTICIPANTS: </jats:bold> Six hundred sixteen individuals aged 60 and older who were hospitalized as the result of a motor vehicle crash between 2002 and 2008 in Western Australia.</jats:p><jats:p> <jats:bold>MEASUREMENTS: </jats:bold> Hospitalization after a motor vehicle crash.</jats:p><jats:p> <jats:bold>RESULTS: </jats:bold> Greater risk for a hospitalization crash was found for older drivers prescribed benzodiazepines (odds ratio (OR)=5.3, 95% confidence interval (CI)=3.6–7.8, <jats:italic>P</jats:italic><.001), antidepressants (OR=1.8, 95% CI=1.0–3.3, <jats:italic>P</jats:italic>=.04), and opioid analgesics (OR=1.5, 95% CI=1.0–2.3, <jats:italic>P</jats:italic>=.05). Crash risk was significantly greater in men prescribed a benzodiazepine (OR=6.2, 95% CI=3.2–12.2, <jats:italic>P</jats:italic><.001) or an antidepressant (OR=2.7, 95% CI=1.1–6.9, <jats:italic>P</jats:italic>=.03). Women prescribed benzodiazepines (OR=4.9, 95% CI=3.1–7.8, <jats:italic>P</jats:italic><.001) or opioid analgesics (OR=1.8, 95% CI=1.1–3.0, <jats:italic>P</jats:italic>=.03) also had a significantly greater crash risk. Subgroup analyses further suggested that drivers with (OR=4.0, 95% CI=2.9–8.1, <jats:italic>P</jats:italic><.001) and without (OR=6.0, 95% CI=3.8–9.5, <jats:italic>P</jats:italic><.001) a chronic condition who were prescribed benzodiazepines were at greater crash risk. Drivers with a chronic condition taking antidepressants (OR=3.4, 95% CI=1.3–8.5, <jats:italic>P</jats:italic>=.01) also had a greater crash risk.</jats:p><jats:p> <jats:bold>CONCLUSION: </jats:bold> Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.</jats:p>