Primary care physicians' knowledge of sleep medicine and barriers to transfer of patients with sleep disorders. A cross-sectional study

Awareness and Knowledge of Parents and Caregivers Regarding Pediatric Obstructive Sleep Apnea in Jazan, Saudi Arabia: A Cross-Sectional Study

Background Pediatric obstructive sleep apnea (POSA) is a common sleep disorder that can cause major health problems if untreated. Parental knowledge and awareness are critical for early detection and management of POSA in children. This study sought to measure parents' and caregivers' knowledge and awareness of pediatric POSA in Jazan, Saudi Arabia, as well as to uncover sociodemographic correlates of knowledge levels. Methods This cross-sectional study was conducted in Jazan, Saudi Arabia. A structured survey was used to collect data on sociodemographic factors and knowledge of pediatric OSA. Data were examined using descriptive statistics, ANOVA, and multivariate logistic regression analysis. Results The study included 393 parents and caregivers, 36.4% of whom were in the 18-30 year age group. Most were Saudis (n=385; 98%), and 212 (53.9%) were men. Most parents (n=378; 96.2%) had limited knowledge of pediatric OSA. Significant knowledge gaps were observed in recognizing POSA symptoms, understanding its impact on children's academic performance, and their association with mental health issues. Internet and social networking sites were the most common sources of knowledge about POSA (n=131; 33.33%), followed by knowing someone with OSA (n=103; 26.21%). Parents with more than eight children had a significant association with more knowledge than those without children (adjusted OR = 10.661, 95% CI: 1.367-83.139, p = 0.024). Conclusion The study identified significant gaps in the recognition of POSA symptoms and understanding its impact on their children's academic performance and mental health. Despite their limited knowledge, parents were receptive to early intervention for POSA. The study suggests that parents with more children had better knowledge of POSA, indicating that experiential learning may contribute to their understanding. The study recommends developing and assessing targeted education and awareness programs for parents, healthcare providers, and the public to improve POSA diagnosis, care, and outcomes.

Translating and establishing the psychometric properties of the Jenkins Sleep Scale for Arabic-speaking individuals

BACKGROUND

The Jenkins Sleep Scale is a widely used self-report questionnaire that assesses sleep quality and disturbances. This study aimed to translate the scale into Arabic and evaluate its psychometric properties in an Arabic-speaking population.

METHODS

The Jenkins Sleep Scale was translated into Arabic using forward and backward translation procedures. The Arabic version was administered to a convenience sample of 420 adults along with the Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) for validation purposes. Reliability was examined using Cronbach's alpha and McDonald's omega coefficients. Confirmatory factor analysis (CFA) was also conducted to test the unidimensional factor structure. Convergent validity was assessed using correlations with PSQI and AIS scores.

RESULTS

The Cronbach's alpha and McDonald's omega values for the Arabic Jenkins Sleep Scale were 0.74 and 0.75, respectively, indicating good internal consistency. The 2-week and 4-week test-retest intraclass correlation coefficients were both 0.94 (p < 0.001), indicating excellent test-retest reliability. The CFA results confirmed the unidimensional factor structure (CFI = 0.99, TLI = 0.96, RMSEA = 0.08). The measurement model had an equivalent factor structure, loadings, intercepts, and residuals across sex, age, and marital status. Significant positive correlations were found between the Arabic Jenkins scale score and the PSQI (r = 0.80, p < 0.001) and AIS (r = 0.74, p < 0.001), supporting convergent validity.

CONCLUSION

The Arabic version of the Jenkins Sleep Scale demonstrated good psychometric properties. The findings support its use as a valid and reliable measure for evaluating sleep quality and disturbances among Arabic-speaking populations.

The effect of single-component sleep restriction therapy on depressive symptoms: A systematic review and meta-analysis

Sleep restriction therapy is a behavioural component within cognitive behavioural therapy for insomnia and is an effective standalone treatment for insomnia, but its effect on depressive symptoms remains unclear. This review aimed to synthesise and evaluate the impact of single-component sleep restriction therapy on depressive symptoms relative to a control intervention. We searched electronic databases and sleep-related journals for randomised controlled trials and uncontrolled clinical trials, published from 1 January 1986 until 19 August 2023, that delivered sleep restriction therapy to adults with insomnia. Random-effects meta-analysis of standardised mean differences and Cochrane risk of bias assessment were performed on randomised controlled trials, while uncontrolled clinical trials were discussed narratively. The meta-analysis was pre-registered on PROSPERO (ID: CRD42020191803). We identified seven randomised controlled trials (N = 1102) and two uncontrolled clinical trials (N = 22). Findings suggest that sleep restriction therapy is associated with a medium effect for improvement in depressive symptoms at post-treatment (Nc  = 6, g = -0.45 [95% confidence interval = -0.70 to -0.21], p < 0.001) and a small effect at follow-up (Nc  = 4, g = -0.31 [95% confidence interval = -0.45 to -0.16], p < 0.001). Five of the seven included randomised controlled trials were judged to have a high risk of bias. Standalone sleep restriction therapy appears to be efficacious for improving depressive symptoms at post-treatment and follow-up. However, conclusions are tentative due to the small number of trials and because none of the trials was performed in a population with clinically defined depression. Large-scale trials are needed to test the effect of sleep restriction therapy in patients experiencing depression and insomnia. Findings also highlight the need to improve the standardisation and reporting of sleep restriction therapy procedures, and to design studies with more rigorous control arms to reduce potential bias.

'It's like tumbleweeds everywhere': An Interpretative Phenomenological Analysis of the lived experience of being diagnosed with and living with narcolepsy

There is a lack of awareness of how sleep health and sleep disorders are experienced. Previous research has found that living with narcolepsy has a debilitating impact on several areas of an individual's life alongside significant diagnostic delays. This study uses a phenomenological, qualitative methodology to explore experiences of being diagnosed with and living with narcolepsy. Six women with type 1 narcolepsy participated in semi-structured interviews. Transcripts were analysed using Interpretative Phenomenological Analysis. Capturing the whole illness experience of narcolepsy, our analysis illuminated three superordinate themes; 'minimising, dismissing and downplaying symptoms', 'navigating the winding journey to diagnosis' and 'a different way of living'. Through our analysis, we are able to demonstrate the affective impact lack of awareness of sleep and sleep disorders has; resulting in significant diagnostic delays and a lack of support post-diagnosis. Findings demonstrate a need for greater awareness and increased support.

Prevalence of Insomnia and Its Associated Factors in the General Population of Saudi Arabia: A Cross-Sectional Study

INTRODUCTION

Insomnia is a common sleep disorder that can have negative impacts on daily functioning and health. However, little is known about the prevalence of insomnia and its associated factors in the general population of Saudi Arabia. This cross-sectional study aimed to investigate the prevalence of insomnia and its associated factors among adults in Saudi Arabia.

METHODS

A self-administered electronic questionnaire was distributed to 4818 participants from all 13 regions of Saudi Arabia. The eight-item Sleep Condition Indicator (SCI) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria was used to assess the prevalence of insomnia.

RESULTS

The results showed that 37.6% of participants met all the DSM-5 clinical criteria for insomnia in the past month. The prevalence was higher among females, divorced or widowed individuals, students, unemployed individuals, those living with friends or family, those reporting severe work stress, and those using mobile devices before sleeping. On the other hand, the prevalence was lower among males, married individuals, morning and evening employees, those who practice physical exercise, and those with good health status.

CONCLUSION

This study found the prevalence of insomnia to be 37.6% in the general population of Saudi Arabia, which is considerably high. The risk factors associated with insomnia in the Saudi population were found to be age, sex, work stress, and using mobile devices before sleeping, while protective factors included being employed, practicing physical exercise, and having good health status. Further research is needed to explore the impact of insomnia on the quality of life and productivity of individuals in Saudi Arabia.

Knowledge and Awareness of Parents About Pediatric Obstructive Sleep Apnea in Jeddah: A Cross-Sectional Study

Background Obstructive sleep apnea (OSA) is relatively common in childhood and is characterized by repeated partial or complete blockages of the upper airway during sleep. Children affected by OSA can experience various symptoms including snoring, restless sleep, and behavioral issues such as hyperactivity, impulsivity, and aggression, which interfere with their quality of life. Additionally, OSA can result in serious conditions such as cardiovascular and metabolic diseases. This study aims to determine the level of knowledge and awareness of OSA among parents in the Jeddah region. Methodology An observational cross-sectional study was conducted to determine the level of awareness of OSA among all parents in Jeddah, Saudi Arabia. Participants were recruited through social media platforms. The online survey assessed the knowledge regarding the OSA definition, risk factors, associated symptoms, and treatment. Results A total of 462 participants were included. Only 16% of participants had a good level of knowledge of OSA, while the remaining 84% had a poor level of knowledge. The mean knowledge score was 15.39 ± 5.8, with a significant difference between occupations (P=0.039). Conclusion Our study reveals that parents in Jeddah, Saudi Arabia have a low level of knowledge about pediatric OSA, with only 16% demonstrating good knowledge and less than half recognizing the definition of OSA. This lack of knowledge could lead to delays in diagnosis and treatment, negatively impacting children's health and academic performance. Common symptoms of OSA reported by parents were restless sleep, mouth breathing, and snoring, but bedwetting and hyperactivity were poorly recognized. Adenoids, allergic sinusitis, enlarged tonsils, asthma, and obesity were identified as risk factors for OSA. Improving parental awareness of OSA through public campaigns, doctor consultations, and education programs is crucial. Further studies are needed to assess the effectiveness of these interventions.

Real-world association of self-reported sleep duration and quality with falls among older adults: A representative nationwide study of China

INTRODUCTION

Falls are the leading cause of injury-related morbidity and mortality among older adults (aged ≥65 years) worldwide. However, previous studies examining sleep and falls were confined to community subpopulations, and few studies included both sleep quality and sleep duration when discussing risk factors of falls. This nationwide representative study aimed to examine the links between sleep duration, sleep quality and falls among Chinese community-dwelling older adults.

METHOD

Cross-sectional analyses were conducted with 14,681 older individuals (aged ≥65 years) from 23 Chinese provinces from the Chinese Longitudinal Healthy and Longevity Study (CLHLS) in 2018. Individual variables, including sociodemographic factors, lifestyle, and behavioral factors, were measured using a self-reported questionnaire. Falls were confirmed through face-to-face interviews. Three multivariate logistic regression models were conducted to assess the association between sleep duration and sleep quality with falls.

RESULTS

There were 21.7% (95%CI: 21.0-22.4%) participants who had experienced falls in the past year. After controlling demographic and individual variables, falls in older adults were associated with self-reported sleep quality and self-reported sleep duration. Those who reported poor sleep quality were more likely to fall (OR = 1.149; 95%CI = 1.004,1.316). Participants who reported sleep duration that was too short (<5) (OR = 1.349; 95% CI = 1.191 to 1.528) or too long (>8) (OR = 1.267; 95% CI = 1.151 to 1.394) were both associated with higher fall prevalence.

CONCLUSION

Nearly one-fifth of older adults in this study had experienced falls in the past year. The study found that falls were significantly associated with less sleep duration, longer sleep duration, and overall poor sleep quality among the old Chinese population.

Awareness of Medical Students toward Circadian Rhythm and Sleep Disorder Based on Biomedical Diagnosis

Background

Sleep disorders affect an individual's mental and physical health and vice versa. Sleep medicine is underrecognized as a specialty; therefore, many sleep disorders go undiagnosed. This study is aimed at assessing the knowledge of medical students toward circadian neuroscience and sleep disorder based on biomedical diagnosis.

Methods

This cross-sectional study was conducted in both male and female medical colleges from the third to the sixth year. A self-administered structured questionnaire consisting of sociodemographic data and the Assessment of Sleep Knowledge in Medical Education (ASKME) survey assessed the students' general knowledge and attitude towards sleep disorder and sleep medicine. Chi-square/Fisher exact tests were used to analyse the participants' knowledge level toward specific sociodemographic data. Also, for two-level continuous variables, the Wilcoxon two-sample test was used.

Results

The total number of participants was 296, with 154 female and 142 male participants. The prevalence of inadequate knowledge was considerable with 96.62% of students, compared to adequate knowledge with only 3.38%. The students' attitude to sleep medicine was negative 14.53% and positive among 85.47%. We found that gender was significantly associated with attitude with a p value = 0.0057. The specific interest in sleep medicine had a significant association with knowledge and attitude, p value of 0.0522 and 0.0059, respectively.

Conclusion

This study concluded that medical students possess inadequate knowledge regarding sleep medicine, yet they have a positive attitude towards it.

Isolated REM sleep behaviour disorder: current diagnostic procedures and emerging new technologies

Isolated REM sleep behaviour disorder (iRBD) is characterised by dream enactment behaviours, such as kicking and punching while asleep, and vivid/violent dreams. It is now acknowledged as a prodromal phase of neurodegenerative disease-approximately 80% of people with iRBD will develop dementia with Lewy Bodies, Parkinson's disease or another degenerative brain disease within 10 years. It is important that neurologists and other clinicians understand how to make an early accurate diagnosis of iRBD so that affected people can have the opportunity to take part in clinical trials. However, making a diagnosis can be clinically challenging due to a variety of reasons, including delayed referral, symptom overlap with other disorders, and uncertainty about how to confirm a diagnosis. Several methods of assessment are available, such as clinical interview, screening questionnaires and video polysomnography or 'sleep study'. This review aims to support clinical neurologists in assessing people who present with symptoms suggestive of iRBD. We describe the usefulness and limitations of each diagnostic method currently available in clinical practice, and present recent research on the utility of new wearable technologies to assist with iRBD diagnosis, which may offer a more practical assessment method for clinicians. This review highlights the importance of thorough clinical investigation when patients present with suspected iRBD and emphasises the need for easier access to diagnostic procedures for accurate and early diagnosis.

Current Management of Residual Excessive Daytime Sleepiness Due to Obstructive Sleep Apnea: Insights for Optimizing Patient Outcomes

Although excessive daytime sleepiness (EDS) attributable to obstructive sleep apnea (OSA) can be resolved by consistent usage of and effective treatment (often with the use of continuous positive airway pressure therapy), 12–58% of patients report residual EDS (REDS). While REDS is difficult to treat, a proportion of cases are possibly due to reversible issues, and wake-promoting medications can prove useful for the remaining cases. Given the challenges associated with effective management of REDS and its relationship to multiple comorbidities, multidisciplinary management of patients with REDS is often recommended. Here we aim to bridge the knowledge gap on the burden, risk factors, prevalence, and potential pathophysiologic mechanisms of REDS in patients with OSA after first-line treatment. The roles of primary care physicians and sleep specialists, as well as the importance of the use of objective assessment tools for the evaluation of REDS and the effective management of comorbidities, are discussed. An update of approved treatments and emerging candidate treatments is also presented.

Improving sleep medicine education among health professions trainees

STUDY OBJECTIVES

Despite increasing recognition of its importance, sleep medicine education remains limited during medical training. We sought to assess the baseline knowledge of a group of health professions trainees and to determine whether an educational sleep medicine "boot camp" led to improvement in sleep medicine knowledge.

METHODS

Participants attended a two-day introduction to sleep medicine course designed for new sleep medicine fellows in July 2017 and 2018. Participants completed two validated sleep knowledge questionnaires (The Assessment of Sleep Knowledge in Medical Education [ASMKE] and The Dartmouth Sleep Knowledge and Attitude Survey [Dartmouth]) prior to and at the conclusion of the course.

RESULTS

A total of 21 health professions trainees including 14 sleep medicine fellows completed both pre- and post-surveys. Baseline ASKME score was 21.4 ± 3.4 out of 30 (71.4% ± 11.4%) and baseline Dartmouth score was 16.1 ± 2.4 out of 24 (67.3% ± 9.9%). There was no difference in baseline scores between sleep medicine fellows and other health professions trainees. There was a statistically significant improvement in ASKME (2.9 ± 2.1 points, p=0.004) and Dartmouth (2.5 ± 3.0 points, p=0.001) scores among all participants after the course, without a difference in degree of improvement among sleep medicine fellows compared to other health professions trainees.

CONCLUSIONS

Our findings suggest that baseline sleep medicine knowledge is higher than previously reported among health professions trainees. An educational sleep medicine boot camp improved knowledge even in a group of learners with high baseline knowledge and interest in sleep medicine, including new sleep medicine fellows.

Knowledge of Sleep Disorders Among Physicians at a Tertiary Care Hospital in Qatar: Cross-sectional Study

Background

Sleep disorders constitute a major health problem because of their relatively high and rising prevalence. Several studies worldwide have analyzed health care providers’ knowledge of sleep disorders.

Objective

In this study, we aimed to assess the knowledge of sleep disorders among physicians in Qatar.

Methods

A total of 250 physicians were surveyed regarding their knowledge of sleep medicine by using the validated 30-item Assessment of Sleep Knowledge in Medical Education (ASKME) Survey. The participants included residents, fellows, and consultants in medicine and allied subspecialties. A high score was defined as ≥60% of correctly answered questions, implying the respondent has adequate knowledge of sleep disorders.

Results

Responses were received from 158 of the 250 physicians, with a response rate of 63.2%. This included responses from 34 residents, 74 clinical fellows, and 50 consultants. The overall mean score was 15.53 (SD 4.42), with the highest possible score of 30. Only 57 of 158 (36.1%) respondents were able to answer ≥60% of the questions correctly. No statistically significant difference was found in the scores of participants with regard to their ranks (ie, residents, fellows, or consultants) or years of medical training.

Conclusions

This study demonstrates that health care providers in Qatar have decreased awareness and knowledge about sleep medicine, which may reflect reduced emphasis on sleep disorders during medical school and training. Increasing awareness regarding sleep medicine among nonspecialist physicians will allow early detection and treatment of sleep disorders, thereby reducing the morbidity associated with these disorders.

Asian accreditation of sleep medicine physicians and technologists: practice guidelines by the Asian Society of Sleep Medicine

Due to the rapid growth in sleep medicine's professional content, several countries have recognized sleep medicine as an independent specialty. The practice of sleep medicine and the demand for this service in Asian countries are expanding. At this point of growth, the accreditation of sleep medicine specialists is paramount to patient care and the training of physicians and technologists. The Asian Society of Sleep Medicine (ASSM) mandated a taskforce committee for the accreditation of sleep medicine practice. This taskforce developed Asian accreditation practice guidelines for sleep medicine physicians and technologists. This paper presents the newly approved Asian accreditation practice guidelines for sleep medicine physicians and technologists by the ASSM.

Why Treat Insomnia?

"Why treat insomnia?" This question grows out of the perspective that insomnia is a symptom that should only receive targeted treatment when temporary relief is needed or until more comprehensive gains may be achieved with therapy for the parent or precipitating medical or psychiatric disorders. This perspective, however, is untenable given recent data regarding the prevalence, course, consequences, and costs of insomnia. Further, the emerging data that the treatment of insomnia may promote better medical and mental health (alone or in combination with other therapies) strongly suggests that the question is no longer "why treat insomnia," but rather "when isn't insomnia treatment indicated?" This perspective was recently catalyzed with the American College of Physicians' recommendation that chronic insomnia should be treated and that the first line treatment should be cognitive-behavioral therapy for insomnia (CBT-I).

The Knowledge of Sleep Medicine among Dental Interns in Northern Jordan

OBJECTIVES

 The diagnosis and treatment of patients with sleep disorders are the most challenging issues in dentistry. The aim of this study was to assess the knowledge among dental interns in Northern Jordan about sleep medicine and sleep disorders.

MATERIALS AND METHODS

 This cross-sectional study was performed using the Assessment of Sleep Knowledge in Medical Education (ASKME) questionnaire. The questionnaire was given to 88 dental interns (52 females and 36 males) in Northern Jordan. Chi-squared test was utilized for data analysis.

RESULTS

 The mean score of the ASKME questionnaire was 12 out of 30 (40%). The majority of dental interns (88.6%) correctly answered ≤ 50% of the questions. No association was found between gender and score results.

CONCLUSIONS

 Dental interns in Northern Jordan have a low level of knowledge about sleep medicine and sleep disorders. Dental faculties should provide courses related to sleep medicine throughout undergraduate education.

Sleep assessment and interventions for patients living with cancer from the patients' and nurses' perspective

BACKGROUND

Difficulty sleeping is a common symptom for patients living with cancer that significantly affects their lives. However, although sleep disorders are common, it is an overlooked problem in cancer care.

PURPOSE

This study assessed the prevalence of sleep disturbances among patients living with cancer, and assessed the adequacy of sleep assessment and intervention for patients from both nurses' and patients' perspectives.

METHOD

Descriptive, cross-sectional and correlational design was used in this study. A convenience sample of 129 patients with cancer and 113 registered nurses working with cancer patients was recruited. A structured face-to-face interview was used to complete the patients' questionnaires and a self-administered questionnaire was given to nurses.

FINDINGS

The majority of patients with cancer reported having poor sleep quality (69.8%). About 86.7% (n=98) of nurses reported that they have never screened patients with cancer for any sleep problems, and 76.7% (n=99) of the patients reported that they have never been assessed for sleep problems by the nursing staff during hospitalisation. Only 8% of patients with cancer who reported having problems sleeping to a nurse received interventions to promote better sleep.

CONCLUSION

Assessment of sleep disturbances in patients with cancer should be unified using a comprehensive reliable valid instrument, as well as providing evidence-based interventions according to patient's need. A written policy should be introduced to encourage sleep documentation and to make sleep care for patients part of routine nursing care.

Application of latent class analysis in assessing the awareness, attitude, practice and satisfaction of paediatricians on sleep disorder management in children in Italy

AIM

To identify subgroups regarding paediatricians' awareness, attitude, practice and satisfaction about management of Sleep-Disordered Breathing (SDB) in Italy using Latent Class Analysis (LCA).

METHODS

A cross-sectional study was conducted on a large sample of Italian paediatricians. Using a self-administered questionnaire, the study collected information on 420 Paediatric Hospital Paediatricians (PHPs) and 594 Family Care Paediatricians (FCPs). LCA was used to discover underlying response patterns, thus allowing identification of respondent groups with similar awareness, attitude, practice and satisfaction. A logistic regression model was used to investigate which independent variables influenced latent class membership. Analyses were performed using R 3.5.2 software. A p-value<0.05 was considered statistically significant.

RESULTS

Two classes were identified: Class 1 (n = 368, 36.29%) "Untrained and poorly satisfied" and Class 2 (n = 646, 63.71%) "Trained and satisfied." Involving paediatric pneumologists or otorhinolaryngologists in clinical practice was associated with an increased probability of Class 2 membership (OR = 5.88, 95%CI [2.94-13.19]; OR = 15.95, 95% CI [10.92-23.81] respectively). Examining more than 20 children with SDB during the last month decreased the probability of Class 2 membership (OR = 0.29, 95% CI [0.14-0.61]). FCPs showed a higher probability of Class 2 membership than PHPs (OR = 4.64, 95% CI [3.31-6.55]).

CONCLUSIONS

These findings suggest that the LCA approach can provide important information on how education and training could be tailored for different subgroups of paediatricians. In Italy standardized educational interventions improving paediatricians' screening of SDB are needed in order to guarantee efficient management of children with SDB and reduce the burden of disease.

Knowledge and Attitude Regarding Sleep Medicine among Medical Students at Qassim University, Saudi Arabia

BACKGROUNDS:

Sleep disorders and sleep medicine are underrecognized by both the general public and health care workers. Lack of education and training in sleep medicine has resulted in a culture of physicians who have very limited knowledge about sleep disorders and, as a result, are likely to underdiagnose and under-treat patients.

AIM:

This study aimed to assess the knowledge of and attitude regarding sleep medicine among medical students at Qassim University.

METHODS:

This was a cross-sectional study of 4^th and 5^th-year medical students, conducted at Qassim University (Central and Unaizah branches), Saudi Arabia. We used a self-administered data collection tool to collect personal information (age, name, sex, medical school), and assessed general attitude toward sleep medicine and the students’ current knowledge about sleep medicine using the Assessment of Sleep Knowledge in Medical Education (ASKME) survey.

RESULTS:

The prevalence of medical students who had a special interest in sleep medicine was 23.3%. Poor knowledge about sleep medicine was detected in 94.8% of students, while good knowledge was observed in only 5.2%. The attitude of the students toward sleep medicine was negative among 40.5% and positive among 59.5%. University branches, gender, and preferred speciality were all significantly associated with attitude score, whereas interest in sleep medicine and knowledge of sleep disorders were associated with both knowledge and attitude scores.

CONCLUSION:

This study found that medical students’ knowledge of sleep medicine was very low, despite the majority of them having a positive attitude toward it.

Assessment of patients' medical fitness to drive by primary care physicians: A cross-sectional study

OBJECTIVES

Motor vehicle collisions (MVCs) are a significant health burden in Saudi Arabia. The literature has consistently indicated that chronic medical conditions, such as diabetes, heart disease, stroke, obstructive sleep apnea, and neurodevelopmental disorders, increase the risk of MVCs. Therefore, assessment of driver fitness by primary care physicians (PCPs) remains a major health intervention that might reduce MVCs. We studied the practices of PCPs in assessing medical fitness to drive in at-risk patients.

METHODS

We conducted a cross-sectional study of all 88 government-funded primary care centers in the city of Riyadh, Saudi Arabia. We administered a self-reported questionnaire to PCPs that inquired about their driving risk assessment for specific medical conditions.

RESULTS

Among all PCPs and centers, 189 PCPs (63%) from 74 centers (84%) participated in our survey. The mean age of the PCPs was 40 ± 10 years, and 108 (57%) were men. The average clinical experience of the group was 13 ± 9 years. Fewer than half of PCPs considered diabetes mellitus (45%) and obstructive sleep apnea (46%) as potential risks for MVCs. Approximately 45% of PCPs did not notify any authority or relatives of potential driving issues that they noticed in their patients. Only 15% of the participants believed that PCPs were responsible for alerting authorities about their fitness to drive.

CONCLUSIONS

PCPs did not adequately assess their patients' driving history and eligibility. Efforts are needed to improve awareness among PCPs regarding the effects of chronic medical conditions on driving.