Patient-centered approaches to mitigate administrative burden in cancer care.

Abstract

408 Background: Cancer treatment often requires patients to manage healthcare-related administrative burden (AB), which is the learning, compliance, and psychological costs associated with non-clinical tasks required to receive treatment (e.g., scheduling appointments, completing paperwork, communicating with payers). Although emerging research has described AB in cancer care, how patients draw on social networks and institutional resources to manage it remains underexplored. Guided by the Burden of Treatment Theory, this qualitative analysis examined how patients with cancer and their informal caregivers experience and respond to AB. Methods: English-speaking adults receiving cancer treatment at an academic medical center in North Carolina were recruited from a medication assistance program; caregivers were recruited via patient referral. One-time, semi-structured interviews were conducted 10/2025–1/2026, recorded, and transcribed. Two researchers independently summarized transcripts using rapid qualitative analysis techniques; a third assessed convergence and produced a consensus summary matrix. The team reviewed the matrix and identified themes through iterative discussion. Results: Twenty-five interviews were conducted. Patients (n=23) were on average 67 years old; most were White (83%) and male (57%). Two caregivers were interviewed. Analysis yielded 5 themes—the first 3 reflect the complexity and inconsistency of AB experiences, and the final 2 offer patient-centered solutions: 1) “‘It takes a village’: Informal and institutional support networks” highlighted the central role of informal caregivers in coordinating logistics and providing support, along with frontline staff who connected patients with available resources and administrative assistance. 2) “The flurry” described the initial post-diagnosis period, when burdens were most intense, anxiety was highest, and responsibility for coordinating care was greatest; for many, burdens tapered as they were connected to institutional and outside resources. 3) “Navigating the maze” reflected ongoing confusion and distress related to bills, medication costs, insurance coverage, and complicated assistance applications. 4) “Tools for mitigation” referred to the self-directed strategies for managing AB, including digital resources (e.g., MyChart) and analog approaches. 5) “Tell us sooner” emphasized patient-proposed changes to reduce burden through early explanations of billing and insurance practices, financial assistance, and points of contact for additional help. Conclusions: Findings suggest that AB can diminish when patients have strong informal and/or institutional support. Institutional programs that provide structured administrative assistance, facilitate early communication, and actively involve informal caregivers can help patients better navigate the administrative aspects of the healthcare system.