Factors Associated with Shared Decision-making and Decisional Conflicts among Patients with Restless Legs Syndrome – A Cross-sectional Study

Introduction: Restless legs syndrome (RLS) is a prevalent disorder that disrupts sleep and impairs quality of life. Establishing effective treatment is complex, and shared decision-making (SDM) might reduce decisional conflicts. No previous study has examined SDM or factors linked to decisional conflicts in RLS. Therefore, this study aimed to explore and compare sociodemographic and clinical factors associated with SDM in general and decisional conflicts in particular among patients with RLS. Methods: A cross-sectional design using a postal survey (June–September 2022), inviting all ~1500 members of the national RLS patient organization. Comparative statistical analyses and logistic regression models examined associations with sociodemographic and clinical factors, using the instruments: Restless Legs Syndrome-6 scale (RLS symptoms), Pittsburgh Sleep Quality Index (sleep), Patient Health Questionnaire-9 (depressive symptoms), eHEALS (e-health literacy), CollaboRATE (SDM), and SURE (decisional conflicts). Ad hoc items regarding treatment satisfaction and informational needs were also used. Results: In total, 788 patients, 65% women, mean age 70.8 (standard deviation = 11.3) were included. Fifty-eight percent reported a low SDM experience, and 78% experienced decisional conflicts. Multiple logistic regression analysis showed that RLS symptoms at nighttime (odds ratio [OR] = 1.073, P = 0.020), RLS treatment dissatisfaction (OR = 2.077, P < 0.001), low e-health literacy (OR = 0.964, P = 0.007), and a low SDM experience (OR = 0.800, P < 0.001) were associated with decisional conflicts. Conclusion: Most patients experienced low levels of SDM and decisional conflicts, with several factors associated with their experiences. Awareness among healthcare professionals can support a collaborative approach, using SDM to prevent treatment-related decisional conflicts in RLS care.