An International Approach to Enhancing a National Guideline on Driving and Dementia

Mark J. Rapoport, Justin N. Chee, David B. Carr, Frank Molnar, Gary Naglie, Jamie Dow, Richard Marottoli, Sara Mitchell, Mark Tant, Nathan Herrmann, Krista L. Lanctôt, John-Paul Taylor, Paul C. Donaghy, Sherrilene Classen, Desmond O’Neill

The purpose of this study was to update a national guideline on assessing drivers with dementia, addressing limitations of previous versions which included a lack of developmental rigor and stakeholder involvement. An international multidisciplinary team reviewed 104 different recommendations from 12 previous guidelines on assessing drivers with dementia in light of a recent review of the literature. Revised guideline recommendations were drafted by consensus. A preliminary draft was sent to specialist physician and occupational therapy groups for feedback, using an a priori definition of 90% agreement as consensus. The research team drafted 23 guideline recommendations, and responses were received from 145 stakeholders. No recommendation was endorsed by less than 80% of respondents, and 14 (61%) of the recommendations were endorsed by more than 90%.The recommendations are presented in the manuscript. The revised guideline incorporates the perspectives of consensus of an expert group as well as front-line clinicians who regularly assess drivers with dementia. The majority of the recommendations were based on evidence at the level of expert opinion, revealing gaps in the evidence and future directions for research.