Strategies to reduce MR SID

Pharmacists add brightly coloured labels to dispensed medications that may cause MR SID and while this information is always included in the information sheet it may be in small print or not highlighted. We should never assume that a person will read and understand these warnings, or that conversations with prescribers or pharmacists have occurred. 

Conversations used in patient education must occur repeatedly, account for the person’s level of health literacy and English literacy and employ strategies such as “teach back” that check for understanding. 

At follow up sessions, it is important to enquire about medication effects and impacts on both driving and decision-making – is the person making the right choices? If anyone identifies an immediate concern about an impaired driver, they should dial 111 and inform the police. 

It is essential people do not stop their medications because they want to drive. Some health conditions, if under- or untreated also affect driving ability.₁₉ A fear by health professionals that a person will stop their medication or reduce their dose if they are concerned about MR SID could lead to softening of the message. Phrases like “refrain from driving” or “practice caution” are often interpreted as advisory only or that there is only low associated risk compared to “do not drive” or “avoid driving”.₂₀ Tools such as those developed by Waka Kotahi provide support for healthcare professionals having these conversations.

Self-identification of impairment, and listening to others who express concern, are key to reducing rates of MR SID. People should be advised to check for symptoms before any driving episode and to avoid alcohol if they are planning to drive while taking high risk medications (NZTA).