Driving disability a challenge for people with axSpA: study

Most patients with axial spondyloarthritis have some difficulty with driving, according to a new study. This can have negative impacts on work for many people.

“Driving presents a unique set of challenges for those with musculoskeletal disease,” wrote study authors led by Dr LaKrista Morton, of the University of Aberdeen, Scotland, UK in Arthritis Care & Research. “The most common clinical manifestations of axial spondyloarthritis affect the neck and spine and yet we know very little about how [it] affects driving ability.”

The researchers analysed data on 718 patients included in the Scotland Registry for Ankylosing Spondylitis (SIRAS). They found that of that cohort, 89% had some difficulty with at least one driving task .

The most frequent task that patients faced difficulty with was sitting in a motor vehicle for long periods (78%), followed by difficulty with getting in or out of the vehicle (72%). A total of 72 patients (10%) had some difficulty with all nine tasks included.

Three domains of driving difficulty were identified, including dynamic driving scenarios, crossing traffic, and the physical act of driving. Factors significantly associated with difficulties across all three domains included chronic widespread pain, knee and back pain, fatigue, high disease activity, and anxiety/depression.

Patients who had retired from work early or who were unemployed due to their health, were more likely to have difficulties across all three domains than those who were employed. But even those in paid employment reported difficulties, with 64% saying that work productivity was affected to some degree; 8% had missed some work in the past seven days.

After adjustment for both sociodemographic factors and clinical characteristics, each of the driving difficulty domains were associated with work-related presenteeism and absenteeism due to axial spondyloarthritis.

“Improving understanding and awareness of driving disability in axial spondyloarthritis will help direct advice and resources to enable patients to remain independent and economically active,” the authors wrote.

“Clinicians need to be enablers rather than arbiters of driving so that patients feel able to seek help.”

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