Measuring the Burden of Time in Oncology: A Literature Review Informing the Development of the Time Toxicity Index
Disciplines
Critical Care Nursing | Medical Pathology | Oncology | Palliative Care | Palliative Nursing | Public Health and Community Nursing
Abstract (300 words maximum)
Purpose: Cancer care advancements have extended survival but introduced new burdens, including time toxicity. Time toxicity refers to the cumulative time patients spend receiving care, including travel, waiting, treatment, and recovery. While increasingly recognized, it remains poorly measured and underrepresented in oncology research. This review explores how time related burdens affect diagnosis, adherence, and quality of life, particularly among underserved populations.
Methods: An integrative literature review was conducted using PubMed, MEDLINE, CINAHL, and Scopus to identify studies from the past five years examining time burden in adult cancer patients. Inclusion criteria required studies to focus on cancer care, patient experiences, and quality of life in relation to time investment. Sixteen studies were selected for thematic analysis, with a focus on informing development of the Time Toxicity Index.
Results: Five core themes emerged: the definition and measurement of time toxicity, its influence on patient and caregiver decision making, impact on quality of life and psychosocial outcomes, system level strategies for mitigation, and implications for research and policy. The findings show that patients often weigh time burden as heavily as clinical benefit, and caregivers also experience secondary time costs. Current measurement tools lack consistency and do not reflect the full scope of patient experience.
Discussion: Future research must incorporate in depth patient interviews to personalize and refine the Time Toxicity Index. These qualitative accounts will capture lived experiences, help identify disparities, and ensure the tool reflects diverse values and care contexts. A patient informed index can support shared decision making, improve treatment adherence, and guide policies aimed at minimizing unnecessary time burdens. Understanding and addressing time toxicity will be essential to advancing truly patient centered oncology care.
Use of AI Disclaimer
no
Academic department under which the project should be listed
WCHHS – Nursing
Primary Investigator (PI) Name
Chinomso Nwozichi
Measuring the Burden of Time in Oncology: A Literature Review Informing the Development of the Time Toxicity Index
Purpose: Cancer care advancements have extended survival but introduced new burdens, including time toxicity. Time toxicity refers to the cumulative time patients spend receiving care, including travel, waiting, treatment, and recovery. While increasingly recognized, it remains poorly measured and underrepresented in oncology research. This review explores how time related burdens affect diagnosis, adherence, and quality of life, particularly among underserved populations.
Methods: An integrative literature review was conducted using PubMed, MEDLINE, CINAHL, and Scopus to identify studies from the past five years examining time burden in adult cancer patients. Inclusion criteria required studies to focus on cancer care, patient experiences, and quality of life in relation to time investment. Sixteen studies were selected for thematic analysis, with a focus on informing development of the Time Toxicity Index.
Results: Five core themes emerged: the definition and measurement of time toxicity, its influence on patient and caregiver decision making, impact on quality of life and psychosocial outcomes, system level strategies for mitigation, and implications for research and policy. The findings show that patients often weigh time burden as heavily as clinical benefit, and caregivers also experience secondary time costs. Current measurement tools lack consistency and do not reflect the full scope of patient experience.
Discussion: Future research must incorporate in depth patient interviews to personalize and refine the Time Toxicity Index. These qualitative accounts will capture lived experiences, help identify disparities, and ensure the tool reflects diverse values and care contexts. A patient informed index can support shared decision making, improve treatment adherence, and guide policies aimed at minimizing unnecessary time burdens. Understanding and addressing time toxicity will be essential to advancing truly patient centered oncology care.