Rendimiento del fruto (t/ha).

Effectiveness:  Cost: Unknown Use: Unknown Time: Long Some medications prescribed by a doctor can pose a risk for drivers. It is important that physicians, pharmacists, and patients receive information about the potential risk of motor vehicle crashes associated with certain medications. Perhaps the simplest way to achieve this would be through clear warning labels on packages. France uses a warning label system that has four categories:

• 0. No warning.

• I. Be careful: Read the patient leaflet carefully before driving.

• II. Be very careful: Seek advice from a physician or pharmacist before driving.

• III. Danger – Do not drive: Seek medical advice before driving again.

Entire classes of drugs may be classified in a particular category. For example, all hypnotic drugs are classified as category III. Any labeling scheme would need to be systematic. Presently in the United States, labeling is inconsistent and dependent on the individual pharmacy/pharmacist. The International Council on Alcohol, Drugs, and Traffic Safety (ICADTS) has developed a categorization system for medicinal drugs that can affect driving performance (ICADTS, 2007). The list was intended for physicians and pharmacists so they could better identify medications that could impair driving skills and look for safer alternatives when possible. In 2008 and 2009, NHTSA convened an expert panel to develop a list of medications (or classes of medications) that may be “safe” for driving; however, the panel found inadequate information about specific medications to develop such a list (Kay & Logan, 2011).

The effects of medications on driving are a particular concern with older drivers. LeRoy and Morse (2008) examined the association between multiple medication use and motor vehicle crashes among people 50 and older. The study found a large percentage of older people (64%) take medications that can potentially impair driving, and those taking three or more impairing medications were 87% more likely to be involved in a crash.

For recent reviews on medications and road safety, see de Gier (2006) and Vandrevala, Helman, Turner, and Stone (2010).

Use and Effectiveness: There is little information available on how frequently this

countermeasure is used in the United States, or how effective it has been in raising awareness, increasing knowledge, or changing behavior. NHTSA has worked with Walgreens, the country's largest drugstore chain, to develop a curriculum for pharmacists on medication-impaired driving. The curriculum includes modules that cover potentially driver-impairing prescription drugs, laws relating to medication use and DUI, and the role of pharmacists in counseling patients regarding medications and driving risk. A pilot test with 640 pharmacists showed the curriculum was effective in increasing pharmacists’ knowledge of medication-related impaired driving (Lococo & Tyree, 2007).

Costs: Targeted education to physicians and pharmacists (through drug categorization systems) and to drivers (through warning labels) would be needed. The former would likely be the most costly.

Time to implement: Targeted communications could require a year or more to plan, produce, and distribute.

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