Care coordination: Improving health outcomes in individuals receiving methadone maintenance treatment

Individuals who are opiate dependent experience a wide range of health disparities and increased mortality. Health risks ranging from untreated chronic disease, infectious disease and trauma disproportionately impact this population. Those individuals who engage in methadone maintenance treatment often maintain regular, sustained contact with professional staff including nurses in the methadone maintenance program. Nurses have the opportunity to positively impact these clients’ health. Literature suggests that care management delivered within the existing methadone maintenance program can improve health outcomes. Structural changes to the personnel, policies and procedures of a large methadone maintenance program in a Massachusetts city enabled nurses to provide care coordination within the program setting. Project involved significant changes to nursing roles and care delivery structure in order to implement evidence-based changes. Lessons learned included the need for involvement of all stakeholders, physical plant adaptations, nursing education and support, coordination of internal and external health records, and plan for additional primary care resources. Implications for implementation and sustaining care coordination in other, similar programs will be discussed.