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Implications of Driver and Vehicle Licensing Agency guidelines in an adult congenital heart disease population

Published online by Cambridge University Press:  18 September 2020

Victoria M. Stoll Open the ORCID record for Victoria M. Stoll [Opens in a new window] ,
Georgina Ooues Open the ORCID record for Georgina Ooues [Opens in a new window]  and
Lucy E. Hudsmith
Victoria M. Stoll*
Affiliation:
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK Department of Adult Congenital Cardiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Georgina Ooues
Affiliation:
Department of Adult Congenital Cardiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Lucy E. Hudsmith
Affiliation:
Department of Adult Congenital Cardiology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
*
Author for correspondence: Dr. Victoria Stoll, DPhil, Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, Medical School, Edgbaston, BirminghamB15 2TT, UK. E-mail: V.m.stoll@bham.ac.uk
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Abstract

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Keywords

Drivingcongenital heart diseaseguidelines
Type
Letter to the Editor
Information
Cardiology in the Young , Volume 30 , Issue 11 , November 2020 , pp. 1753 - 1754
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

Recent guidance from the Driver and Vehicle Licensing Agency states that symptomatic patients with congenital heart disease (CHD) should not drive and must notify the Driver and Vehicle Licensing Agency. 1 We sought to understand the impact this new guidance would have upon our patients.

Methods

We designed and conducted a prospective survey regarding driving practices in adult CHD patients attending for outpatient review at a Level 1 surgical centre.

Results

In total, 103 consecutive patients completed the survey. The median age range was 25–34 years (total range 16–74 years). Overall, 48% of respondents were female. Thirty-four (33%) patients did not possess a driving licence, whilst 57 (55%) held a current driving licence and the other 12 (12%) were learning to drive. All of the drivers had a Group 1 licence (car/motorcycle); there were no Group 2 licence holders (bus/lorry). In total, 78% of drivers owned a car. Ten patients had a blue badge, whilst 12 patients were recipients of mobility allowance.

The main reasons for car usage were getting to work, visiting friends/family, and shopping (Fig 1a). Figure 1b demonstrates the use of public transport for all patients surveyed. Amongst those who drive, 19 (28%) never used public transport, with only 4 (6%) using it daily.

Figure 1. ( a ) Reasons for car usage amongst patients with driving licences/learning to drive. ( b ) Frequency of public transport utilisation in all patients surveyed.

Of the 69 patients with driving licences/learning to drive, 48 (70%) patients had previously undergone an operation. Thirty-three of these patients (48%) were prescribed cardiac medications. Two patients in total had an implantable cardioverter defibrillator, with one of these being a current driver. Forty-four (64%) patients with driving licences/learning to drive had symptoms within the last 6 months. The two most common symptoms were palpitations in 29 patients (42%) and exertional dyspnoea in 27 patients (39%).

In total, 35 (51%) licence holders/learners knew they could report their medical condition via the Driver and Vehicle Licencing Agency website. Twelve patients had contacted the Driver and Vehicle Licencing Agency about their heart condition and all of them found them to be helpful.

Conclusions

In total, 64% of our patients who drive had symptoms that according to the new Driver and Vehicle Licencing Agency guidance could preclude them from driving. Our survey results show our patients are reliant on driving for their daily activities. Therefore, the recent Driver and Vehicle Licencing Agency guidance is likely to result in significant social and financial difficulties for our patients and requires further clarification for such patients. We are designing an information leaflet for our patients to provide them with further advice and guidance upon these recent Driver and Vehicle Licencing Agency requirements.

Acknowledgements

None.

Author contributions

All authors contributed to the design and data collection, analysis, and revision of the letter.

Financial support

Dr Stoll is funded by the National Institute of Health Research as a Clinical Lecturer.

Conflicts of interest

None.

Ethical Standards

This project was approved by the University Hospitals Birmingham NHS Foundation Trust.

References

“Assessing fitness to drive- a guide for medical professionals,” DVLA. August 2018. https://www.gov.uk/government/publications/assessing-fitness-to-drive-a-guide-for-medical-professionals.Google Scholar
Figure 0

Figure 1. (a) Reasons for car usage amongst patients with driving licences/learning to drive. (b) Frequency of public transport utilisation in all patients surveyed.