Schizophrenia, antipsychotic treatment adherence and driver responsibility for motor vehicle crash: a population-based retrospective study in British Columbia, Canada

ObjectiveTo examine the relationship between schizophrenia, antipsychotic medication adherence and driver responsibility for motor vehicle crash.DesignRetrospective observational cohort study using 20 years of population-based administrative health and driving data.SettingBritish Columbia, Canada.Pa...

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Bibliographic Details
Published in:BMJ open 2024-07, Vol.14 (7), p.e080609
Main Authors: Staples, John A, Daly-Grafstein, Daniel, Khan, Mayesha, Pei, Lulu X, Erdelyi, Shannon, Rezansoff, Stefanie N, Chan, Herbert, Honer, William G, Brubacher, Jeffrey R
Format: Article
Language:English
Subjects:
ACCIDENT & EMERGENCY MEDICINE
Accidents, Traffic - statistics & numerical data
Adult
Aged
Antipsychotic Agents - therapeutic use
Antipsychotics
Automobile Driving
British Columbia
Criminal investigations
Driving Under the Influence
EPIDEMIOLOGY
Family physicians
Female
GENERAL MEDICINE (see Internal Medicine)
Health policy
Humans
Insurance industry
Insurance policies
Licenses
Licensing
Logistic Models
Male
Medication Adherence - statistics & numerical data
Mental disorders
Mental Health
Middle Aged
Original Research
Psychotropic drugs
Retrospective Studies
Risk Factors
Schizophrenia
Schizophrenia & psychotic disorders
Schizophrenia - drug therapy
Traffic accidents & safety
Young Adult
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Summary:ObjectiveTo examine the relationship between schizophrenia, antipsychotic medication adherence and driver responsibility for motor vehicle crash.DesignRetrospective observational cohort study using 20 years of population-based administrative health and driving data.SettingBritish Columbia, Canada.ParticipantsLicensed drivers who were involved in a police-attended motor vehicle crash in British Columbia over a 17-year study interval (2000–16).ExposuresIncident schizophrenia was identified using hospitalisation and physician services data. Antipsychotic adherence was estimated using prescription fill data to calculate the ‘medication possession ratio’ (MPR) in the 30 days prior to crash.Primary outcome measuresWe deemed drivers ‘responsible’ or ‘non-responsible’ for their crash by applying a validated scoring tool to police-reported crash data. We used logistic regression to evaluate the association between crash responsibility and exposures of interest.ResultsOur cohort included 808 432 drivers involved in a police-attended crash and for whom crash responsibility could be established. In total, 1689 of the 2551 drivers with schizophrenia and 432 430 of the 805 881 drivers without schizophrenia were deemed responsible for their crash, corresponding to a significant association between schizophrenia and crash responsibility (66.2% vs 53.7%; adjusted OR (aOR), 1.67; 95% CI, 1.53 to 1.82; p
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2023-080609