Medication use and the risk of motor vehicle collision in West Virginia drivers 65 years of age and older: a case-crossover study

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Background: The current generation of older adults reports a higher lifetime prevalence of prescription, over-thecounter, and recreational drug use. The purpose of this analysis is to characterize the drug usage and determine the risk of motor vehicle collision associated with individual medications in a population of drivers ≥65 years. Methods: A case-crossover study was conducted at West Virginia University Healthcare’s facilities using data obtained from the electronic health records (n = 611) of drivers ≥65 years admitted for medical treatment following a motor vehicle collision which occurred between Jan. 1, 2009 and June 30, 2014. Patients’ medication usage 14 days before collision were matched and compared to their medication usage during four control periods prior to collision. Odds ratios were then calculated for the most prevalent individual medications and pharmaceutical sub-classes using conditional logistic regression. Results: Analgesic, cardiovascular and gastrointestinal medicines were common. Few drivers tested positive for either licit or illicit drugs. Of those testing positive for drugs, benzodiazepines and opiates were prevalent. Drivers consuming Tramadol (adjusted OR 11.41; 95 % CI 1.27, 102.15) were at a significantly increased risk of motor vehicle collision. Conclusions: Older adult drivers who have a prescription for this medication may need to be aware of the potential risk. Further research is necessary in a larger, more nationally representative population.