Patient-, care partner-, and clinician-proposed solutions to address the time toxicity of cancer care

Purpose: As the concept of time toxicity has gained traction in the oncology community, work has largely focused on mapping and measuring time burdens. This qualitative study sought to elicit perspectives from people with lived or professional experience with cancer care on strategies to decrease the time burden of oncology care. Methods: We conducted semi-structured interviews with 47 participants (16 patients with advanced gastrointestinal cancer, 15 of informal care partners, and 16 oncology clinicians with diverse roles) from a single academic cancer center in Minneapolis, Minnesota. Interviews were conducted between February 2023 and October 2023 and transcribed and analyzed using a hybrid approach. Results: Five key themes emerged as solutions to address time toxicity: (1) tailored ambulatory scheduling based on patient and care partner needs; (2) improved administrative and logistical support; (3) home-based care when safe, feasible, and preferred; (4) transparent and empathetic communication of time demands, and (5) innovative care models and delivery. Participants emphasized that the threshold between helpful and burdensome care in the context of a cancer diagnosis differs for each person, requiring individualized solutions. Conclusion: Findings from this study will aid the oncology community in considering and designing interventions to decrease the time burdens of cancer care on patients and their care partners. Implementing changes to meet the need for individualized, person-centered interventions, focusing on individuals’ preferences and unique circumstances, will require health system will and motivation.