700 Section - The CanDrive Older Driver Risk Stratification Tool: Pilot Implementation in Dementia Care Clinic Settings

This pilot study examined the feasibility and acceptability of implementing the CanDrive Risk Stratification Tool (RST) in dementia clinics, where clinicians make driving-related decisions for older adults with cognitive impairment. Developed prospectively with 928 Canadian drivers, the four-item RST screens medical fitness to drive using at-fault crashes as the primary outcome. The study evaluated training ease, usability, clarity, and relevance for guiding structured conversations about driving safety.

Design:

Clinicians first completed a one-hour training session on administering and interpreting the tool, followed by a pre-implementation survey capturing baseline attitudes and anticipated challenges. During a three-month trial, practitioners used the RST during patient visits, typically requiring five minutes for administration and an additional five minutes for scoring and explanation. A post-implementation survey assessed changes in perceptions, confidence, and experiences.
 

Results:

Seventeen clinicians participated, and twelve completed the post-survey. Engagement remained strong throughout the trial, and participants showed willingness to integrate the tool into clinical discussions. By the end of the three months, 83% reported using the RST when disclosing a dementia diagnosis associated with driving concerns. Communication benefits were evident, with 58% indicating that the tool helped them explain risk categories more clearly to patients and families. Perceived clinical utility was positive: 83% felt the RST was effective in identifying potential crash risk, and 66% agreed that its risk estimates were appropriate. These findings suggest initial acceptability, meaningful integration into practice, and early evidence that the RST can enhance clinician confidence and patient understanding during driving-related conversations.

Conclusion:

Overall, this pilot study demonstrates that the RST can be implemented in a specialized dementia-care setting and provides support for fitness-to-drive assessments. Insights related to training, workflow integration, and communication will guide future implementation efforts aimed at embedding the RST across diverse clinical settings to promote safer driving outcomes for older adults.