Development and preliminary evaluation of the classification system of prescription drugs affecting traffic safety

Abstract

Introduction: Driving under the influence (DUI) has been a growing traffic safety issue in many countries in recent decades. Drivers who use medicinal drugs affecting driving performance are at a higher risk of traffic crashes than the other drivers. This is due to the complexity of driving, which requires simultaneous interaction with the vehicle and the external environment. Taking certain medications can affect driving process and endanger traffic safety. Therefore, this study was conducted to develop and evaluate a classification system for prescriptional drugs affecting traffic safety. Materials and Methods: This research is a mixed-method study and was conducted in four phases from 2020 to 2022. At first, a systematic review was conducted regarding drug classification systems in traffic safety. Then, medicinal drugs listed in Iranian pharmacopeia were classified using the DRUID system. The third phase included developing the drug and driving web-based system. After developing this system, it was evaluated in two stages: quantitative study (cross-sectional, descriptive-analytical) and qualitative study (content analysis). The information obtained from the evaluation studies were used to improve and modify the drug classification system. Results: In this study, 22 warning and classification systems concerning drugs and traffic safety were identified, which had different characteristics. Due to the comprehensiveness of the DRUID system, it was used to categorize medicinal drugs of Iranian pharmacopeia based on the influence on driving. Out of 1255 drugs, 767 were not classified due to insufficient evidence. Of 488 classified drugs, 43.85% belonged to level zero, 25.41% to level one, 13.94% to level two, and 10.4% to level three. 70.66% of dangerous drugs (levels two and three) were related to medicines affecting nervous system. Information of 1255 drugs was entered into the designed system. Then this system was evaluated quantitatively and qualitatively. A quantitative evaluation was conducted among 400 people via a researcher-made questionnaire. The standardized average score was 77.80 ±18.37, and the highest score was related to the system's ease of use (80.48±16.60). Semi-structured interviews were conducted with 23 health experts and software engineers. Seven themes were extracted and integrated with the opinions of the expert panel and were utilized to improve the system. Conclusion: Developing a classification system for drugs affecting driving and developing prescribing guidelines based on their impact on traffic safety can help physicians and pharmacists prescribe medicinal drugs with the least effect on driving. In addition, launching a drug and driving system in Iran can provide useful DIM-related instructions and recommendations for physicians and people. These measures may lead to reduce crashes due to driving under the influence of the drugs.