Work Package 7 - Dissemination & Guidelines
Work Package-leader: Han de Gier, University of Groningen, Department of Pharmacotherapy and Pharmaceutical Care, Netherlands
The objectives of this work package are to review the state-of-the-art and documented effectiveness of existing campaigns and practice guidelines regarding psychoactive substances focussed on the general public and health care professionals, the development of information materials aimed at the general public and health care professionals and a proposal for improving the procedures for assessing fitness to drive.
A review will be conducted including existing campaigns on prevention of driving under the influence of psychoactive substances. The focus will be on campaigns aimed at the general public (mass media, multimedia, printed media, brochures) and on programs for physicians and pharmacists (continuous education, brochures). This inventory will be completed with examples from other countries such as Australia (for example State of Victoria) and the United States.
In addition to the materials used for the campaigns, information will be sought on the impact of these campaigns (if available), as well as on the design of effective campaigns and how to evaluate their impact. In particular, for continuous education of professionals, the application of new knowledge for safer use of drugs that can impair driving will be explored. Searches of the literature will be extended by consultation of experts through various international organizations (International Council on Alcohol, Drugs and Traffic Safety ICADTS, FERSI, the Pompidou group of the Council of Europe and the Working Group on Alcohol, Drugs, Medicines and Driving from DG TREN).
Guidelines and professional standards
The scope and effectiveness of professional medical and pharmaceutical standards will be discussed with European organisations of physicians and pharmacists. In developing guidelines and protocols for improving prescribing and dispensing practices specific attention will be given to the opportunities of using Information and Communication Technology (ICT) in the computerised information systems that physicians and pharmacists use in their daily practice. In these approaches the role of health care professionals in case psychoactive substances other than medicines will be used by their patients will be addressed.
The existing medical guidelines for assessing fitness to drive within the framework of Council Directive 91/439/EEC (on driving licences) will be evaluated on the basis of legal outcomes in the event of accidents occurring after a positive decision from a physician’s side. After reviewing some best practices a proposal for implementing improvements in legislation and procedures will be presented.
Various documents and brochures for dissemination of information regarding psychoactive substances and driving will be developed. These documents will be addressed to the general public (regarding medication and driving), drivers as patients (regarding how diseases/medication can affect driving) with special attention to younger drivers (regarding multiple drug use, for example cannabis in combination with alcohol or ecstasy), physicians and pharmacists (counselling the patient-driver regarding medication and driving), and policy makers and other public bodies.
Multimedia support in developing these materials is important as well as the assessment of the impact of the various means of communication.
Evaluation and implementation of new technologies
The implementation of practice guidelines and protocols for medical and pharmaceutical care will be investigated. After a baseline measurement of knowledge and attitudes towards prescribing and dispensing psychoactive medicines to patients who drive among groups of general practitioners, medical specialists and community pharmacists in the Netherlands, Belgium, Spain, and Germany interventions will be evaluated based on a questionnaire survey and focus group discussions. Collaboration with researchers in those countries can provide insight in differences depending upon existing conditions with respect to the application of ICT and working relationships of the different professionals in these countries. After educating health care professionals based on new information, such as a categorization system for medicinal drugs affecting driving performance, guidelines and protocols, as well as brochures for counselling patients, their knowledge and attitudes will be assessed again to show the impact of the intervention.
The availability of new materials for counselling patients will offer opportunities to evaluate the effectiveness of risk communication to patients who use psychotropic medicines and to drug consumers regarding psychoactive substances affecting driving performance. After a baseline measurement of knowledge and attitudes towards driving while using impairing substances among patients and drug users, the effectiveness of new ways to communicate risk to these target groups will be evaluated. Based on a questionnaire survey among patients who receive psychotropic medication in community pharmacies and drug consumers, knowledge and attitudes before and after the introduction of newly developed tools for risk communication will be assessed. By investigating the patient satisfaction in all practices where health care professionals used new tools for counselling their patients the outcomes of the implementation can be further defined.