Categorization and labeling systems concerning driving-impairing medicines: A scoping review

Design, development, and evaluation of a multi-lingual web-based database for informing people regarding driving-impairing medicines

OBJECTIVE

Driving under the influence of drugs (DUID) is a growing traffic safety problem in many countries. It is estimated that 5 to 10% of medicinal drugs may impair driving due to their side effects. Despite the high number of medicinal drugs prescribed in Iran, there is a lack of a database that could provide specialized information regarding medicinal drugs and driving. Therefore, the present study aimed to design, develop, and evaluate a database for informing the general public, drivers, and healthcare providers regarding driving-impairing medicines.

METHODS

The Drugs-and-traffic-safety (DATS) database, which has been developed by Road Traffic Injury Research Center (RTIRC), was designed using Java, HTML, JavaScript and MySql database. After completing the testing process, pharmaceutical data (i.e., generic and brand names, route of administration, anatomical classification, etc.), the level of influence of medicinal drugs on driving, and driving-related recommendations based on the level of influence for consumers were entered into the database. A cross-sectional study, and a qualitative study as semi-structured interviews and expert panels were conducted in different target groups to evaluate the DATS. Finally, the evaluation results were used to improve the database. The quantitative and qualitative data were analyzed using SPSS 25.0 and MAXQDA-10, respectively.

RESULTS

The DATS was the only web-based database that could be accessed online via different browsers. The database included information about 1,255 medicinal drugs, and their influence on driving was shown with four colors, i.e., green (insignificant or no effect), yellow (mild effect), orange (moderate effect), and red (severe effect). The database was designed in multiple languages, which could enable users to search for medicinal drug names in both Persian and English. Based on the quantitative results, the mean score of the DATS was 75.10 ± 16.01 (out of 100) from the public viewpoint, indicating that the users were relatively satisfied with the database. Some themes and subthemes were extracted from the qualitative section of the study which revealed the users found DATS a practical, useful, and user-friendly tool.

CONCLUSION

Considering the positive feedback of users about DATS in the quantitative and qualitative evaluations, implementing DATS in Iran could provide useful advice in terms of the influence of medicinal drugs on driving to the public and traffic users. Therefore, it can raise public awareness of the risk of driving under the influence of medicinal drugs.

Pedestrians' unsafe road-crossing behaviors in Iran: An observational-based study in West Azerbaijan

OBJECTIVE

Pedestrians are one of the most vulnerable users in road traffic injuries (RTIs). The rate of pedestrians' fatality is high in Iran. It is worthwhile to investigate how pedestrians behave. This observational study aimed to investigate pedestrians' unsafe behaviors while crossing.

METHODS

This cross-sectional study examined the behavior of 1095 pedestrians (69.7% men) using videotaping when they crossed at two intersections and three non-intersections on a weekend and two working days in the morning, at noon, and in the evening. The information obtained was classified into 5 domains including adherence to traffic rule, violation, environmental barriers, visibility, and distraction. Data were analyzed using Stata version 17.

RESULTS

About 60% of the pedestrians ignored the crosswalk and crossed the street wherever they wanted. More than 30% ignored the vehicles passing and crossed the street inattentively. About 60% of the pedestrians committed violations. More than half of pedestrians crossed unsafe crossings diagonally or in a hurry. More than 35% wore dark clothing and had low visibility, and nearly 30% were distracted. Adolescent pedestrians did not adhere traffic rules about 6 times more than the young adult pedestrians. Pedestrians who did not adhere to traffic rules in the morning were significantly more than in the evening. Men committed a violation 1.47 times more than women. The results showed that the pedestrians committed a violation in the morning significantly more than in the evening.

CONCLUSION

The occurrence of pedestrians' unsafe behaviors in Maku was high. Unsafe behaviors were high among men and young adult pedestrians. Therefore, it's essential to implement educational interventions via different media as well as environmental interventions by different organizations to improve safe behavior among pedestrians.

Adaptation of a European categorization system for driving-impairing medicines in Iran

OBJECTIVE

Road traffic crashes due to impaired driving are a leading cause of preventable injuries and deaths. The purpose of this study was adaptation of a European categorization system for driving-impairing medicines in Iran.

METHODS

DRUID categorization system was used as a leading model to classify medicines. Medicines that were compatible with DRUID categorization system were identified and classified accordingly. Medicines that were not compatible with DRUID categorization system were assessed in an expert panel in terms of possiblity of classification. Instructions for health care providers and advice for patients were prepared based on the medicine's influence on fitness to drive.

RESULTS

Of the 1255 medicines in Iranian pharmacopeia, 488 medicines were classified in four categories. Among classified medicines 43.85% and 25.41% belonged to Category 0 and Category 1. About 13.94%, 10.04%, and 6.76% pertained to Category 2, Category 3, and Multiple categories respectively. Majority of the medicines with moderate and severe adverse influences on driving fitness belonged to the nervous system medicines (72.65%). Most of the medicines with non-existing or minor adverse influences on driving fitness pertained to cardiovascular medicines (16.56%). Majority of uncategorized medicines belonged to Iranian herbal medicines.

CONCLUSION

The current study disclosed that DRUID categorization system was implementable for most of the commonly prescribed medicines. Experimental studies are needed to determine the influence of uncategorized medicines of Iranian pharmacopeia. Other countries with similar settings can adapt DRUID categorization system until they develop their own model using original studies.