Interview with Noah Webster, MA

Why is it that despite doctor's orders to refrain from driving, some patients with epilepsy drive nonetheless? Patients with uncontrolled seizures generally are not able to legally drive and usually are advised not to by their physicians. Noah Webster, Sociology, Case Western Reserve University and colleagues from the Cleveland Clinic attempted to determine why some patients with epilepsy disregard medical advice and continue to drive. They presented their findings at the recent annual meeting of the American Epilepsy Society.

Webster and Farrah M. Thomas, PsyD, Neurology, Cleveland Clinic, told epilepsy.com during an interview: "Few studies have examined why patients with epilepsy disregard medical advice and continue to drive. One of our goals in conducting this study was to find out what characteristics or behaviors are related to driving in order to better understand the reasons behind this behavior."

Methods

According to the investigators, 301 adults (56% female, 89% Caucasian, 43% married, 41% employed full or part-time) between the ages of 18-75 with medically intractable epilepsy who had been referred for surgery evaluation at the Cleveland Clinic participated in a health psychology evaluation that included a chart review for demographic, disease, and health-related information. Driving characteristics were assessed with questions about license status, whether or not they were currently driving, and the number of seizure-related motor vehicle accidents (MVAs).

Results

The study noted that 19% of the sample were currently driving, 49% had a current license, and 33% had been in at least 1 seizure-related MVA. Patients more likely to be driving were males, current license holders, not on disability, not presenting anxiety-related disorders, and never involved in a seizure-related MVA.

Conclusions

The researchers noted: "Driving with epilepsy is a serious concern with tremendous risk of injury to self, others, and property, and states vary widely in their regulation of driving."

One explanation put forth by the authors as to why patients continue to drive is that they are receiving inconsistent messages from providers who may be unfamiliar with state laws. The researchers ask the question "are consistent laws preventing patients with epilepsy from maintaining a valid license the answer?" However, they did note: "Results suggest the reasons patients continue to drive is not straightforward."

The team is asking some key questions whose answers they wish to explore with further research:

  • What do physicians and patients know about state laws? And what role do inconsistent messages play in this behavior?
  • How do families influence driving patterns?
  • How does the availability of and access to public transportation influence driving decisions?

"We realize that driving is an important aspect of independent living and of those who were not driving, approximately half listed driving as a goal for epilepsy surgery," Webster concluded.

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The study, Correlates of Driving Status among Epilepsy Patients, was presented by ¹Noah Webster, ²Peggy Crawford, and ²Farrah M. Thomas from the following institutions(s): ¹Sociology, Case Western Reserve University, Cleveland, OH; and ²Neurology, Cleveland Clinic, Cleveland, OH.

Authored By: 
Rita Watson MPH
Noah Webster MA
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Authored Date: 
12/2006