Journal of substance use and addiction treatment · 2026
Examining patient and provider experiences in collaborative, low threshold care for substance use disorder: A qualitative study of a bridge clinic.
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Bidgood Megan, Sharma Samata, Singer Jefferson A, Suzuki Joji
Аннотация
INTRODUCTION: Individuals with substance use disorders (SUD) face significant barriers to treatment including health comorbidities, structural obstacles, and stigma. Bridge Clinics offer a novel low-threshold, multidisciplinary approach to SUD treatment designed to transition patients to longer-term care. This study explores patient and provider experiences within a hospital-based Bridge Clinic to optimize treatment approaches.
METHODS: We conducted 11 semi-structured interviews with patients (n = 5) and multidisciplinary providers (n = 6) at a hospital-based bridge clinic in Boston, MA. Interviews were recorded, transcribed verbatim, and analyzed using an inductive-deductive thematic approach (framework method with reflexive thematic analysis). Reporting followed the Consolidated criteria for reporting qualitative research (COREQ) checklist.
RESULTS: Five crosscutting themes emerged. (1) Low threshold, nonjudgmental access fostered trust, transparency, and rapid engagement, including same-day medications. (2) Whole person, integrated care addressed substance use, psychiatric comorbidity, infectious disease, and social needs through a biopsychosocial lens. (3) Team based collaboration among addiction psychiatry, internal medicine, primary care, social work, and recovery coaching was the engine of comprehensive care and a source of provider support. (4) Resource allocation and navigation, especially recovery coaching, social services linkage, and harm reduction education were pivotal to progress. (5) Bridging to longer-term care remained the most challenging step, with providers citing out-of-network bottlenecks, limited time for follow-up, and relationship-based hesitancy to hand off care; participants proposed a dedicated referral/bridging specialist.
CONCLUSION: The Bridge Clinic model successfully engages patients through flexible, stigma-free, comprehensive care delivered by collaborative teams. However, challenges remain in optimizing transitions to longer-term treatment and ensuring culturally competent care. Recommendations include developing dedicated bridging specialists and enhanced cultural competence training to improve model implementation and patient outcomes.
METHODS: We conducted 11 semi-structured interviews with patients (n = 5) and multidisciplinary providers (n = 6) at a hospital-based bridge clinic in Boston, MA. Interviews were recorded, transcribed verbatim, and analyzed using an inductive-deductive thematic approach (framework method with reflexive thematic analysis). Reporting followed the Consolidated criteria for reporting qualitative research (COREQ) checklist.
RESULTS: Five crosscutting themes emerged. (1) Low threshold, nonjudgmental access fostered trust, transparency, and rapid engagement, including same-day medications. (2) Whole person, integrated care addressed substance use, psychiatric comorbidity, infectious disease, and social needs through a biopsychosocial lens. (3) Team based collaboration among addiction psychiatry, internal medicine, primary care, social work, and recovery coaching was the engine of comprehensive care and a source of provider support. (4) Resource allocation and navigation, especially recovery coaching, social services linkage, and harm reduction education were pivotal to progress. (5) Bridging to longer-term care remained the most challenging step, with providers citing out-of-network bottlenecks, limited time for follow-up, and relationship-based hesitancy to hand off care; participants proposed a dedicated referral/bridging specialist.
CONCLUSION: The Bridge Clinic model successfully engages patients through flexible, stigma-free, comprehensive care delivered by collaborative teams. However, challenges remain in optimizing transitions to longer-term treatment and ensuring culturally competent care. Recommendations include developing dedicated bridging specialists and enhanced cultural competence training to improve model implementation and patient outcomes.