Pharmacists’ Role in Road Safety: A Qualitative Study on Driving While Using Prescribed Opioids

After two decades of steady decline, Australia’s reduction in road crash fatalities has plateaued. A concerning trend is the increasing presence of prescribed potentially driving-impairing medications (PDIMs), particularly opioids, in driver autopsies. Patients receiving opioid prescriptions often lack adequate guidance about potential cognitive impairment. Pharmacists are well-positioned to offer such advice, yet their perspectives and experiences are rarely documented. This study aimed to explore pharmacists’ experiences, perceptions, and opinions regarding the dispensing of prescribed opioids, with a focus on the advice they provide on driving safety. Additionally, it sought to understand pharmacists’ potential roles in enhancing road safety. Ten pharmacists from the regional city of Toowoomba, Queensland, participated in semi-structured interviews conducted between November 2019 and November 2021. Interviews were transcribed and analyzed using reflexive thematic analysis to identify key themes. This research is part of a larger project exploring how doctors and pharmacists perceive their responsibilities in ensuring driving safety for patients and the broader community. Ethical approval was obtained from the Queensland University of Technology Research Ethics Committee (Reference no: 1900000374), and the study was in accordance with the Australian National Statement on Ethical Conduct in Human Research. Participants provided written informed consent at least five days after receiving detailed project information. The analysis identified three major themes: balancing road safety with personal freedom and independence, collaboration and communication with general practitioners (GPs), and variation in the scope of advice regarding opioid-related impairment and tolerance. Pharmacists recognized the potential road safety risks but were empathetic to the autonomy driving provides. Effective communication and a team-based approach with GPs emerged as key subthemes. While pharmacists offered comprehensive information about cognitive impairment, explicit references to driving were limited. Most learning about medication-related driving risks occurred informally, through on-the-job experience. Enhancing pharmacists’ knowledge and skills regarding opioids could better equip opioid-medicated drivers (OMDs) to make informed driving decisions. Strengthening the collaborative relationship between pharmacists and GPs may further improve road safety outcomes for OMDs.

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