Administrative Workload and Associated Distress in Individuals Undergoing Cancer Therapy

Cancer care is burdensome, but patient experience with time and administrative burdens is variable. Our objective was to assess the association between daily administrative tasks, time spent, and reported burden and identify demographic and clinical predictors.

Participants (n = 122) from two longitudinal studies of individuals receiving cancer treatment utilized a mobile application (Daynamica) to track time spent on cancer care tasks over 28 days. Participants reported distress levels (NCCN Distress Thermometer) and time spent on three administrative tasks daily: scheduling appointments, managing medical bills/claims, and arranging support/transportation. Relationships between distress and tasks were assessed using generalized linear mixed models.

Most participants (91.8%) performed at least one administrative task during the study. Participants were more likely to report clinically significant distress (score 4+) on days involving administrative tasks (scheduling [OR = 1.92, 95% CI: 1.40-2.64], managing bills [OR = 2.10, 95% CI: 1.34-3.29], or arranging support [OR = 3.56, 95% CI: 2.19-5.79]) compared to days without these tasks. While the median time spent was low (14 min per week; Q1-Q3: 3-39), the top quartile spent an average of 83 min per week on these tasks. Lack of reliable transportation was the only factor significantly associated with increased time spent on administrative tasks (median 57 vs. 10 min/week, p = 0.01); no other demographic or clinical factors were associated with higher workload.

Administrative burden is a distinct psychological stressor for individuals with cancer, regardless of the actual time required for administrative tasks. Interventions should focus on streamlining insurance, care coordination, and administrative processes to reduce patient distress.

ClinicalTrials.gov identifier: NCT05708703, NCT06322992.