Palliative care specialists infrequently discuss driving safety with their patients with cancer when prescribing opioids.

Abstract

Opioids may impair the ability to drive especially when prescribed for the first time or when the dose is increased. Because driving is closely associated with independence and quality of life, discussions regarding driving safety should be an integral part of prescribing opioids. However, little is known about the frequency with which palliative care specialists address this issue in clinical practice. In this pilot study, an anonymous survey was conducted among palliative care specialists to evaluate whether driving safety is discussed when prescribing opioids. The survey was distributed to advanced practice providers and physicians from a palliative care service of a tertiary cancer center, and 61 of 72 (85%) completed it. Fifty-seven (93%) respondents considered assessing patients' driving status to be important, and 58 (95%) agreed that driving is an important part of the quality of life of the patients. However, only 28 (46%) reported that they often discuss driving safety in general, and responses were lower when patients were on chronic opioids: 24 (39%) when the morphine equivalent daily dose (MEDD) was ≥100 mg whereas only 13 (21%) did so when the MEDD was ≤50 mg. In addition, just 20 (33%) frequently discuss driving safety when the dose is increased, and only 13 (21%) were familiar with local driving regulations regarding opioid prescribing. Despite recognizing the importance of driving safety, palliative care specialists infrequently address driving safety and opioids with their patients. Educational interventions, increased awareness of local regulations, and standardized preprinted information for patients may improve counseling and promote safer opioid prescribing practices.