EQ-5D-5L Measurement in Bulgarian Community Pharmacies: A Cross-Sectional Study of Published Patient Data and a New Pharmacist Survey to Inform a Prospective Feasibility Study

Bulgaria lacks routine EQ-5D-5L data collection and a national value set, so domestic health technology assessment relies on imported utility values. This study evaluated whether existing evidence justifies a feasibility study of routine EQ-5D-5L measurement in community pharmacies. In this cross-sectional study, reported according to STROBE, we analysed secondary data from a previously published pharmacy-based patient survey and primary data from a new pharmacist survey on questionnaire-based mental health screening, and used both to specify its design. In the source study (n = 119), complete EQ-5D-5L data were obtained from all enrolled participants (mean utility 0.72, 95% CI 0.679–0.756), with directionally consistent known-groups differences; the number of patients approached, administration time and acceptability were not reported. Among surveyed pharmacists (n = 105; convenience sample, response rate not calculable), 80.0% would undertake training and 75.2% would participate in a screening service given clear referral procedures; leading constraints were lack of confidential space (79.0%), time (64.8%) and trained staff (56.2%). Familiarity with PHQ-9/GAD-7 was associated with greater willingness (risk difference 20.5 percentage points, 95% CI 3.9–35.9). EQ-5D-5L-specific readiness was not assessed. Because key feasibility parameters are unknown, a prospective multicentre feasibility study is justified; its endpoints and provisional progression criteria are specified.