Latest / Becker's Healthcare Behavioral Health / Dr. Colby Newsome, Director of Behavioral Health Pharmacy at Appalachian Regional Healthcare

Transcript

Dr. Colby Newsome, Director of Behavioral Health Pharmacy at Appalachian Regional Healthcare · Becker's Healthcare Behavioral Health

• 0:01
  The Becker's team is excited to announce the
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  launch of our new CFO and Revenue Cycle
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  podcast.
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  Tune in for conversations with finance experts from
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  the top hospitals and health systems. We'll discuss
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  revenue cycle podcast wherever you listen to episodes.
• 0:24
  Welcome everyone to the Becker's Healthcare podcast series.
• 0:27
  I'm Mariah Muhammad, writer and moderator with Becker's
• 0:29
  Healthcare. And I'm thrilled to have with me
• 0:31
  today doctor Colby Newsome, director of behavioral health
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  pharmacy at Appalachian
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  Regional Healthcare. Doctor, welcome to the podcast. We're
• 0:39
  very excited to have you join us today.
• 0:41
  To get us started, would you mind please
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  just introducing yourself, and telling us a bit
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  about your background, your organization?
• 0:47
  Yeah. Thank you for having me on today.
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  So, my name is Colby Newsome, and I
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  serve as the director of behavioral health pharmacy
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  at Appalachian Regional Healthcare or ARH.
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  It is a not for profit health system
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  operating 14 hospitals across Southeastern Kentucky and South,
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  Southern West Virginia.
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  I earned my doctorate of pharmacy degree from
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  East Tennessee State University's Bill Gatton College of
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  Pharmacy in 02/2015.
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  And upon graduation,
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  I joined Hazard ARH, where I primarily worked
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  in the emergency department while gaining
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  experience in various clinical settings.
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  During my tenure,
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  I played a key role in
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  establishing ARH's antimicrobial
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  stewardship program and contributed to the development of
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  several clinical protocols.
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  In 02/2018,
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  a childhood friend and I acquired one of
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  the oldest independent pharmacies in our hometown.
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  And following that
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  year, ARH acquired Highlands ARH,
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  and I transitioned there to the role of
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  clinical coordinator.
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  In this capacity, I helped expand
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  and enhance clinical operations,
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  growing the team to include two clinical pharmacists,
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  one emergency care pharmacist,
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  and one critical care pharmacist.
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  In 02/2023,
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  I was appointed the director of pharmacy at
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  Highlands,
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  but my passion for direct patient care led
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  me to join the behavioral health team the
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  following year.
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  Currently, ARH operates three state funded inpatient behavioral
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  health units,
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  and my role allows me to blend administrative
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  leadership with hands on clinical care.
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  I develop policies, procedures, and protocols
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  for behavioral health initiatives,
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  present new psychopharmaceuticals
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  to the system pharmacy and therapeutics committee, and
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  actively participate in ARH's three behavioral health treatment
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  teams,
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  assisting with initiation,
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  adjustment,
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  monitoring
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  of medication therapies.
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  Additionally,
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  my experience as a speaker for BioXcel's Bureau
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  on Agony and Agitation Management
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  has given me the opportunity
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  to collaborate with our emergency departments on optimizing
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  care for behavioral health patients
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  while, experiencing acute agitation in the emergency department
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  setting.
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  I'm passionate about advancing behavioral health pharmacy and
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  improving patient outcomes through evidence based clinical practice
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  and interdisciplinary
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  collaboration.
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  Wonderful. Thank you so much for giving us
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  that background.
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  So the first real question I wanted to
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  ask you, what opportunities and headwinds do you
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  kinda have your eye on right now,
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  of anything that you're,
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  kinda wanting to know about, for this year?
• 3:28
  Yeah. I see several opportunities that I think
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  is beneficial in our health system,
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  and I'll go through a few of those.
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  Long acting injectable antipsychotics
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  or LAIs.
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  You know, poor adherence to treatment is the
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  leading cause of relapse and rehospitalization
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  and schizophrenia,
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  contributing to higher relapse rates, significant patient
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  distress, and substantial economic burden.
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  One of the primary challenges in schizophrenia treatment
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  is improving adherence and promoting sustained engagement with
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  antipsychotic
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  therapy.
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  LAIs have been shown to be as effective
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  as oral antipsychotics
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  and managing schizophrenia,
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  yet they remain underutilized.
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  LAIs
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  offer several advantages over oral therapy, particularly in
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  addressing adherence related challenges
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  by ensuring consistent medication delivery and reducing the
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  risk of missed doses.
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  Advances in LAI technology and delivery systems continue
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  to enhance their efficacy and patient acceptance.
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  Also in the realm of substance use disorder
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  or SUD,
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  SUD remains a significant
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  public health crisis profoundly impacting our service area.
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  Addressing this challenge requires
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  opportunities for improvement
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  include expanding the use of medications for opioid
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  use disorder,
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  increasing the availability and distribution of naloxone to
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  prevent opioid related overdoses,
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  strengthening
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  detoxification
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  services
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  and improving overall access to care. By prioritizing
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  these initiatives,
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  we can make meaningful
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  progress in combating SUD and improving patient outcomes
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  within our community.
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  We also have a lot of treatment resistant
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  depression in our,
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  service area.
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  For decades, psychiatric treatment for treatment for depression
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  has primarily focused on modulating serotonin,
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  norepinephrine,
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  and dopamine.
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  However, emerging research highlights the critical role of
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  glutamate, the brain's most abundant neurotransmitter
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  in mood regulation.
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  This breakthrough
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  has led to the development of novel, rapid
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  acting antidepressants
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  targeting the glutamate pathway, many of these which
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  are now covered by major health insurances.
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  The most recent FDA approved antidepressant
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  laboring this mechanism
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  has demonstrated significant improvements in depressive symptoms within
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  a week as evidenced by clinical trials.
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  For individuals who have not responded to two
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  or more traditional antidepressants,
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  it is essential to explore alternate
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  evidence based treatment options.
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  Health care providers should discuss a range of
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  available therapies with their patients to determine the
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  most, effective approach for their specific needs.
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  And lastly, pharmacogenomics.
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  Genetic variations influence individual responses to medications.
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  This area of research has been viewed as
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  a potential strategy for optimizing the efficacy of
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  many medications and mitigating adverse drug reactions,
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  especially in the realm of behavioral health.
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  Yeah. Thank you so much for sharing that
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  information. Definitely sounds like you got your eye
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  on a a lot of things, especially for
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  this year.
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  How are you thinking about growth and kinda
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  adding value to your organization and or department?
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  Yeah. So I'd like to, you know, go
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  back to the opportunities that we discussed, and,
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  that that's where I really see adding growth
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  and value to our organizations.
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  So with their long acting antipsychotics,
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  I've been actively engaged in their treatment teams,
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  advocating for early and frequent use of LAIs
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  to improve treatment adherence and patient outcomes.
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  Additionally, I continuously
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  assess emerging LAI therapies for potential
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  inclusion on our formulary.
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  Many pharmaceutical companies offer free hospital programs to
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  offset inpatient medication cost, and I've worked diligently
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  to expand our hospital's access to these programs.
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  Looking ahead, I plan to enhance the transitions
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  of care for patients initiated on LAIs.
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  While significant effort is dedicated to stabilizing inpatients
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  and optimizing their treatment regimens,
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  the impact is diminished if the patients are
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  lost to follow-up after discharge.
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  To address this, I intend to collaborate with
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  our ambulatory care pharmacist to strengthen
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  the continuity of care, improve post discharge adherence,
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  and expand access to LAIs in outpatient settings.
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  With SUD,
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  I've collaborated with multiple disciplinary teams to update
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  policies and protocols for medications for opioid use
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  disorder,
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  ensuring alignment with best practices and improving patient
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  outcomes.
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  My efforts have included supporting and promoting the
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  bridge clinic and emergency department
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  to revising
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  the initiation protocols for buprenorphine in acute inpatient
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  settings for patients interested in in MOUD.
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  To further harm reduction, I've worked to expand
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  access to naloxone
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  for patients with SUD.
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  Our emergency department have peer support specialists who
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  assist with harm reduction strategies and provide naloxone
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  to at risk patients at home.
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  I'm also working to streamline naloxone distribution
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  in our emergency department by ensuring that it
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  is readily available through our Pyxis device units,
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  eliminating delays associated with outpatient pharmacy prescriptions
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  and the meds to beds program.
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  These initiatives aim to improve access,
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  reduce barriers to treatment, and enhance patient safety.
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  So for treatment resistant depression, you know, I
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  recently attended the NEI fall con congress where
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  I listened to a talk featuring two psychiatrist
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  and a patient
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  who had been successfully treated with SPRAVATO.
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  Prior to this, I'd already been working on
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  developing and implementing SPRAVATO clinics at two of
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  our outpatient behavioral health centers. However, hearing firsthand
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  about the profound impact this treatment had on
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  the patient further
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  reinforced the urgency and importance of bringing these
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  clinics to fruition at ARH.
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  As stated in that discussion,
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  if a provider is not at least discussing
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  the potential benefits of SPRAVATO with a TRD
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  patient, they are filling that patient.
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  Given the significant number of individuals
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  who have not responded to two or more
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  traditional antidepressants,
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  these clinics have the potential to provide
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  critical evidence based treatment alternatives that can substantially
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  improve patient outcomes.
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  And with pharmacogenomics,
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  I've been collaborating with, the multidisciplinary team to
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  pilot a project implementing
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  pharmacogenomic
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  testing in our inpatient behavioral health units.
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  While our average length of stay is approximately
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  seven days, we also have patients with extended
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  admissions due to placement challenges and other
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  factors, as well as a subset of individuals
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  with high recidivism
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  rates.
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  In these cases, pharmacogenomic
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  testing has the potential to significantly enhance treatment
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  outcomes by optimizing the efficacy
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  of,
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  psychotropic medications
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  and reducing the risk of adverse drug reactions.
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  By incorporating this precision
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  medication approach,
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  we aim to improve medicine selection,
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  enhance patient stability, and ultimately support long term
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  success.
• 10:49
  Wow. That definitely sounds amazing. And and definitely
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  the the definition of growth for sure.
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  It definitely sounds, like a investment, obviously. But
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  is there another
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  risk or another investment that you think is
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  kinda worth making this year?
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  Yeah. You know, going back to SUD, it
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  remains a critical public health crisis, especially in
• 11:12
  Appalachia
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  being particularly affected.
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  The region faces pressing need for additional facilities
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  that can provide acute medical detoxification
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  services
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  to support individuals in the early stages of
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  recovery.
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  Establishing a comprehensive medical
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  detox program would be a vital step in
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  addressing this crisis, offering patients a safe and
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  structured
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  environment for withdrawal management under medical supervision.
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  Expanding access to these services
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  within our health care system would significantly enhance
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  patient outcomes and provide a much needed resource
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  for our community.
• 11:49
  Yeah. It definitely sounds like it for sure.
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  And, doctor, before I let you go, the
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  last thing I really wanted to ask you
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  is where do you see the best opportunities
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  for growth in the future, whether it's your
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  own department or just in your organization or
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  just in health care overall?
• 12:04
  Yeah. So, you know, the first issue of
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  2025 in the American Journal of Psychiatry,
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  it's entirely dedicated to psychedelic sciences,
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  reflecting the growing potential of this field. Additionally,
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  there is a clear trend toward the expansion
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  of holistic and accessible care models,
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  which I foresee is playing a central role
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  in the future of health care in general.
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  Got it. Got it. Yeah. Thank you so
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  much for those final thoughts, doctor. This has
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  definitely been a very informative discussion.
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  So, again, I wanna thank you so much
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  for coming on Becker's Healthcare, especially for the
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  first time. Time. Glad to have you. And
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  I look forward to connecting with you again
• 12:40
  soon.
• 12:40
  Yeah. Thank you for having me on.