A Qualitative Exploratory Study on Developing and Selecting Potential Bolt-on for the EQ-5D Hong Kong Sar, China

OBJECTIVES:

The EQ-5D was built as a multi-attribute utility system to measure Health-related Quality of Life (HRQoL) and discussions on additional bolt-on dimensions had been emerging. The development of bolt-ons should be systematic to respect the generic nature of the original EQ-5D model, while the proposed bolt-on should improve the comprehensiveness and responsiveness of HRQoL measurements. This study aimed to identify and develop appropriate EQ-5D bolt-on dimensions for the Hong Kong community.

METHODS:

Thirty face-to-face individual interviews were conducted in March to August 2021 and the sample mix was designed based on gender, age group and education level composition of census data. A pool of potential bolt-on dimensions was prepared in advance to enhance the flow of the interview while participants were encouraged to propose any related items. Interview transcripts were analysed thematically, and ranking exercise was performed to support qualitative-quantitative comparisons.

RESULTS:

Sample respondents often summed up HRQoL as the ability of ‘walk well, move well, eat well and sleep well’ which matched with local saying and slangs, while two-third of the participants reported that the current EQ-5D-5L was not comprehensive enough to describe HRQoL. The result of the interview transcripts and ranking exercises consistently showed that the sample had preferred ‘Sleeping Quality, ‘Interpersonal Relationship’ and ‘Satisfaction’ as potential EQ-5D bolt-on dimensions. Among the three shortlisted, ‘Sleeping Quality’ recorded the highest coding frequency and majority of respondents stated that poor sleeping quality had been a major HRQoL issue in the Hong Kong.

CONCLUSIONS:

This study provided empirical qualitative evidence to select potential EQ-5D bolt-on dimensions with respect to the culture and characteristics of the Hong Kong community. Future research may focus on testing and quantifying the improvements imposed by introducing bolt-on dimensions, to enhance accurate health utility derivation by the EQ-5D instrument and support the development of patient-centred care in a long run.