Source: Annual Congress 2009 - Socio-economic and epidemiological aspects of sleep apnoea
Disease area: Sleep and breathing disorders

Abstract

Introduction
Patients with obstructive sleep apnoea (OSA) are at risk of road traffic accidents. In the UK, they are required to inform the Driver and Vehicle Licensing Agency (DVLA). For those reporting in writing, the DVLA informs the sleep physician. Those contacting by phone are advised by non-medical call centre staff who can issue a letter of fitness to drive without clinical involvement. In our Centre, OSA patients are advised to inform the DVLA but we believe that concordance is low.
Methods
We undertook a retrospective review on DVLA reporting rates. We then sent a reminder to non-reporters. From new OSA patients between Aug 07-Aug 08, we identified those for whom a medical report was issued to the DVLA. The remainder were regarded as not having informed the DVLA and were sent a reminder. Re-evaluation was conducted after 8 weeks.
Results
Of 271 patients with OSA, 79(29.1%) informed the DVLA after clinic consultation. The remaining 192 were sent a reminder. 65 (33.9%) replied that they had informed the DVLA by telephone and were told fit to drive. Of these, 24/65 were clinically unfit, showing 36.9% analytical disagreement between clinician and call centre assessments. 19/192 (9.9%) informed the DVLA as a result of our intervention. No response was available for the remaining 108/192 (57.8%). 52 (48.1%) of these were unfit.
Conclusions
We conclude that driving advice from clinicians is poorly adhered. Simple reminders have little impact. Telephone contact to the DVLA call centre results in different fitness-to-drive assessment outcomes. Further analysis is needed to explore the high discordance rate. In the interim we suggest that patients should be advised to contact DVLA in writing.

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Citations should be made in the following way:
M. Kyi, A. Proctor, C. Billings, S. Bianchi (Sheffield, United Kingdom). Driving towards a change to DVLA reporting in obstructive sleep apnoea/hypopnoea syndrome?. Eur Respir J 2009; 34: Suppl. 53, 3673

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