Is driver licensing restriction for age-related medical conditions an effective mechanism to improve driver safety without unduly impairing mobility?

BackgroundWhile medical conditions have been recognised as a minor contributing factor to road traffic crashes, clinicians and driver licencing agencies need mechanisms for promoting safe mobility for those with age-related illnesses which can impact on driving safety. Restrictive licensing has been proposed as a possible intervention for decreasing the risk of crashes associated with medical crashes, whilst not unduly affecting patient mobility.ObjectiveTo analyse how the term “restrictive licensing” is defined in the literature, and to determine the effectiveness of this mechanism in improving driver safety.DesignA systematic literature review.MethodsA search of the Medline and TRID databases.ResultsRestrictive licensing is most commonly defined as a geographical, time of day or speed restriction placed on the driver. Personal and vehicle modifications are considered by some to also be a form of restrictive licensing. Existing studies are supportive of the efficacy of restrictive licensing programs, with reduced crash rates for drivers carrying restricted licences compared to controls.ConclusionRestrictive licensing has been shown to be an effective mechanism of increasing driver safety without unduly impacting driver mobility. It has significant potential to have a positive impact on the ability of those with medical conditions to drive safely. Further research is needed to determine the optimum format and policies for advising driver restrictions for age-related disease and disability.