Poor effect of guideline-based treatment of restless legs syndrome in clinical practice

Clinicians have long recognised the gap between the impressive results of treatments in published randomised controlled trials (RCTs), and what can be achieved with those same treatments in practice. This leads to doubt-am I using the treatment correctly, on the right patients? The study by Godau et al 1 highlights this disparity (see page 1390 ).

In their observational study, they reported the effect of applying guideline-based treatments to 100 patients with restless legs syndrome (RLS) over 12 months. Although 90% of patients reported a subjective reduction in their RLS symptoms with dopaminergic drugs, this did not translate into improvements in quality of life or an RLS-specific rating score; this, despite 70% of patients adhering to treatment protocols. There are methodological aspects to criticise-patients were selected via an invitation in the press, suggesting possible recruitment bias, the study was short (although much longer than most of the RCTs), and the numbers were small. But these do not obscure the result-guideline...