This study aimed to assess the adequacy of EQ-5D-5L in defining health as perceived by Malaysians
using a mixed methodology approach. Potential additional dimensions (i.e. bolt-on items) to supplement
the current instrument were also explored. This study was carried out in two phases. In phase one, focus
group discussions (N = 6-8 in each group) were employed to gauge the perception of Malaysians on the
dimensions deemed important additions to the EQ-5D-5L instrument. Phase two involved further
validation of bolt-ons to the EQ-5D-5L using a cross-sectional survey of 100 general public in Penang,
Malaysia. A total of 11 bolt-ons were identified from phase 1. These bolt-ons were sleep, vitality,
happiness, close relationships, stress, mental abilities, social support, religion, vision, hearing, and
speaking. In phase 2, the bolt-ons of ‘vitality’ and ‘stress’ stood out with 70% (n=70) and 64% (n=64)
participants reported facing most problems with, respectively. Both phases of study suggest that
additional dimensions for the existing EQ-5D-5L instrument may be useful to better capture the HRQoL
among Malaysians. Larger scale study is warranted to further validate the bolt-ons identified in this
study.