Contemporary challenges and strategies for improving outcomes for patients with restless legs syndrome

Restless legs syndrome (RLS) is a common neurological disease that is diagnosed solely based on clinical symptoms and may be treated via both nonpharmacologic and pharmacologic means. Despite its somewhat trivial-sounding name, this disease has a very significant impact upon the lives of RLS patients and imposes a substantial burden, as evidenced by direct and indirect costs and loss of productivity. After the introduction of US Food and Drug Administration (FDA)- approved drugs for the management of RLS in 2005, there has been an increase in the awareness of the disease. Increased awareness of RLS has resulted in a greater number of patients receiving treatment for RLS, and in turn, more patients presenting with refractory RLS, in part due to drug-emergent issues such as augmentation. Furthermore, management of the disease is still not optimal. Barriers to obtaining adequate treatment include healthcare providers' lack of knowledge, limited availability of specialists who can provide care to patients presenting with refractory RLS, and access to and cost of medications. Opportunities for managed care to enhance the recognition and treatment of RLS are discussed, with suggestions for improving outcomes in patients with RLS.