Search

Objectives Implementing medical cannabis (MC) into a child’s daily routine can be challenging and there is a lack of guidance for its therapeutic use in schools in Canada. Our objective was to learn about the experiences of caregivers of school-aged children who require MC. Methods Qualitative description was used and caregivers were interviewed about MC in schools and in general. The transcripts were entered into Dedoose software for qualitative analysis and content analysis was performed. Sentences and statements were ascribed line by line into meaning units and labelled with codes, and organized according to categories and subcategories. Results Twelve caregivers of school-aged children who take MC participated. The most common reasons for treatment were drug-resistant epilepsy (DRE), autism, or other developmental disorders. Approximately half of the participants’ children (n = 6) took MC during the school day and most (5/6) perceived their experiences to be positive or neutral but reported a lack of knowledge about MC. While data saturation was not reached regarding MC in schools, rich dialogues were garnered about MC in general and three categories were identified: challenges (subcategories stigma, finding an authorizer, cost, dosing, and supply); parents as advocates (subcategories required knowledge, attitudes, skills, and sources of information); and caregiver relief for positive outcomes. Conclusions Caregivers demonstrate remarkable tenacity despite the many challenges associated with MC use. Education and practice change are needed to ensure that children using MC can benefit from or continue to experience its positive outcomes within the school environment and beyond.

Objectives Guidance is lacking for medical cannabis use in Canadian schools in both legislation and approach; the impact of ambiguous policy on patient care is unknown. A qualitative study was undertaken to explore the experiences of clinicians who care for school-aged children who take medical cannabis. Methods Semi-structured interviews were recorded and transcribed verbatim. Qualitative content analysis performed using the Dedoose qualitative software ascribed meaning units and codes, which were further consolidated into categories and subcategories. Results Thirteen physicians were interviewed virtually, representing seven provinces in Canada. The physicians provided care for between five and hundreds of school-aged children who took medical cannabis. The most common indications were refractory seizure disorders and autism. The interviews provided rich descriptions on perceptions of medical cannabis in schools, and in general. Five overarching categories were identified across both domains including variability, challenges (subcategories: lack of knowledge, stigma, lack of policy, and pragmatic challenges), potential solutions (subcategories: treat it like other medications, communication, education, and family support), positive experiences and improvements over time. Conclusion In Canada, cannabis-based medicine use in schools still faces important challenges. Effective education, communication, family support and policy refinements that allow cannabis to be treated like other prescription medications are recommended to improve the status quo. These findings will guide the C4T Medical Cannabis in Schools Working Group’s future priorities and initiatives.

Medical cannabis (MC) may offer therapeutic benefits for children with complex neurological conditions and chronic diseases. In Canada, parents, and caregivers frequently report encountering barriers when accessing MC for their children. These include negative preconceived notions about risks and benefits, challenges connecting with a knowledgeable healthcare provider (HCP), the high cost of MC products, and navigating MC product shortages. In this manuscript, we explore several of these barriers and provide recommendations to decision-makers to enable a family-centered and evidence-based approach to MC medicine and research for children.

–Much literature has focused on statistical inference for misclassified response variables or misclassified covariates. However, misclassification in both the response variable and the covariate has received very limited attention within applied fields and the statistics community. In situations where the response variable and the covariate are simultaneously subject to misclassification errors, an assumption of independent misclassification errors is often used for convenience without justification. This article aims to show the harmful consequences of inappropriate adjustment for joint misclassification errors. In particular, we focus on the wrong adjustment by ignoring the dependence between the misclassification process of the response variable and the covariate. In this article, the dependence of misclassification in both variables is characterized by covariance-type parameters. We extend the original definition of dependence parameters to a more general setting. We discover a single quantity that governs the dependence of the two misclassification processes. Moreover, we propose likelihood ratio tests to check the nondifferential/independent misclassification assumption in main study/internal validation study designs. Our simulation studies indicate that ignoring the dependent error structure can be even worse than ignoring all the misclassification errors when the validation data size is relatively small. The methodology is illustrated by a real data example.

Background: Since cannabis has been legalized in Canada for medical and recreational use, there has been an increased demand on pharmacists for cannabis counselling. The objective of this study was to determine the concerns, beliefs and attitudes of Canadian pharmacists and pharmacy students towards using cannabis. Methods: An online survey was synthesized under 3 broad themes: concerns, beliefs and attitudes about cannabis, consisting of 27 questions capturing demographics and Likert scale responding to survey questions. We examined whether there were differences in responses by geographic location (i.e., Ontario, Quebec, Canada), sex or practice setting (i.e., community, hospital). Results: Across Canada, there were 654 survey respondents, with 399 in Ontario and 95 in Quebec. Approximately 24% indicated they had used cannabis since legalization, 69% indicated they believed cannabis should be available for medical and recreational use and 34% indicated their perceptions towards cannabis had become more positive since legalization. Relative to Quebec or the rest of Canada, respondents from Ontario were significantly more likely to be comfortable providing counselling to and answering questions of patients on the safety and efficacy of medical cannabis use. Examining sex differences across Canada, male respondents were more comfortable than female counselling patients on the safety and efficacy of medical cannabis. Conclusion: The current results reinforce the perceived need by pharmacists and pharmacy students for targeted education, and future research in cannabis education should consider potential gender differences in attitudes and beliefs surrounding cannabis therapy.

Introduction: Patients awaiting lung transplantation must learn new information to successfully navigate the transplant process. A supplemental video series was piloted to patients at home during the Covid-19 pandemic to improve pre-transplant education. Methods: A mixed methods study was undertaken to assess patient experiences with this method of education, confirm the ideal timing of the education, and identify gaps that require further attention. Semi-structured interviews were conducted with 17 one-on-one or dyadic (patients and caregivers) who viewed the video series at home. A third-party researcher (not involved in creation of the educational materials) conducted the interviews by phone, which were audio recorded and then transcribed verbatim. NVivo 12 Pro for Windows software was used to code the data and identify emerging themes. Results: Participants indicated that home-based videos were applicable, and informative and helpful (4.7 on 5-point Likert scale) and appreciated the advice and experiences of real patients. They were satisfied with their transplant education (4.2/5). While there were few aspects that the participants disliked about the videos, the interviews elicited outstanding questions about the transplant process (eg, logistical aspects of travel) and transplant concerns (eg, medications, expenses, and precautions in daily life). Conclusion: Patients being assessed or listed for lung transplant valued the novel electronic video education, and we will implement the home-based process into standard of care after the patient's initial visit with the transplant respirologist. Pre-transplant education will be tailored to help address the outstanding gaps identified in this program evaluation.

Introduction:Adverse symptoms experienced by solid organ transplant recipients remain largely unexplored despite their purported frequency.Objective:To characterize patient perspectives on adverse symptoms, identifying the most problematic symptoms and the perceived cause and treatability, and to evaluate their impact on quality of life (QoL) and medication adherence.Methods:An electronic survey was distributed to members of the Canadian Transplant Association, to characterize perceptions on symptom experience (Modified Transplant Symptom Occurrence and Distress Scale), and QoL (Short Form-12), medication adherence (Basel Assessment of Adherence to Immunosuppressive Medications Scale), demographics, and clinical situation.Results:The questionnaire was distributed to 249 solid organ transplant recipients and achieved a 51% response rate (N = 127). Respondents reported a mean of 25 (standard deviation 10) adverse symptoms each. In women, the most prevalent and distressing symptoms were tiredness, lack of energy, sleep difficulties, difficulty concentrating or memory problems, diarrhea, joint pain, and depression. In men, they were tiredness, flatulence, lack of energy, sleep difficulties, and erectile problems. With the exception of flatulence, these symptoms were more often perceived to be caused by medical conditions rather than by immunosuppressants or other medications. Quality of life was similar to the general public, with mean physical and mental component scores of 47.4 (9.9) and 52.1 (8.2), respectively (relative to a US average of 50 [10]). However, QoL scores inversely correlated to the number of symptoms reported and were higher in patients who perceived all symptoms to be treatable.Conclusion:Adverse symptoms may impact patient well-being. Perceived cause and treatability should be further explored.

A concerning number of kidneys (eg, expanded donor criteria, extended criteria, or marginal kidneys) are discarded yearly while patients experience significant morbidity and mortality on the transplant waitlist. Novel solutions are needed to solve the shortage of kidneys available for transplant. Patient perceptions regarding the use of these less than ideal kidneys remain unexplored.To explore the perspectives of patients who have previously received a less than ideal kidney in the past and patients awaiting transplant who could potentially benefit from one.Qualitative description study.2 provinces in Canada participated (Saskatchewan and Manitoba).Patients with end-stage kidney disease who were awaiting kidney transplant and were either (a) aged 65 years and older, or (b) 55 years and older with other medical conditions (eg, diabetes).Criterion sampling was used to identify participants. Semi-structured, one-on-one interviews were conducted virtually, which explored perceived quality of life, perceptions of less than ideal kidneys, risk tolerance for accepting one, and educational needs to make such a choice. The interviews were transcribed verbatim and thematic analysis was used to analyze the data.15 interviews were conducted with usable data (n = 10 pretransplant; n = 5 posttransplant). Participants were a mean of 65.5 ± 8.8 years old. Four interrelated themes became prominent including (1) patient awareness and understanding of their situation or context, (2) a desire for information, (3) a desire for freedom from dialysis, and (4) trust. Subthemes of transparency, clarity, standardization, and autonomy were deemed important for participant education. The majority of pretransplant participants (n = 8/10) indicated that between 3 and 5 years off of dialysis would make the risk of accepting a less than ideal kidney feel worthwhile.The study setting was limited to 2 Canadian provinces, which limits the generalizability. Furthermore, the participants were homogenous in demographics such as ethnicity.These findings indicate that patients are comfortable to accept a less than ideal kidney for transplant in situations where their autonomy is respected, they are provided clear, standardized, and transparent information, and when they trust their physician. These results will be used to inform the development of a new national registry for expanding access to deceased-donor kidney transplant.Not registered.De nombreux reins sont rejetés chaque année (donneurs à critères élargis, critères étendus ou reins marginaux), alors que les patients qui attendent une greffe présentent une morbidité importante et un taux de mortalité élevé. De nouvelles solutions sont nécessaires pour contrer la pénurie de reins disponibles pour une transplantation. Les perceptions des patients quant à l’utilization de ces reins moins idéaux restent inexplorées.Explorer les perceptions des patients ayant reçu un rein moins idéal dans le passé et des patients en attente d’une greffe qui pourraient potentiellement bénéficier d’un tel don.Étude qualitative et descriptive.Deux provinces canadiennes (Saskatchewan et Manitoba).Des patients atteints d’insuffisance rénale terminale en attente d’une transplantation (a) âgés de 65 ans et plus ou (b) âgés de 55 ans et plus et présentant d’autres problèmes de santé (ex. diabète).L’échantillonnage avec critères a été utilisé pour identifier les participants. Des entretiens individuels semi-structurés menés virtuellement ont exploré la qualité de vie perçue, la perception quant aux reins moins idéaux, la tolérance à l’égard des risques inhérents à l’acceptation d’un tel rein, et les besoins d’information pour faire ce choix. Les entrevues ont été transcrites intégralement et l’analyze des données a été réalisée par analyze thématique.Quinze entrevues avec données utilisables ont été menées (n = 10 avant la greffe; n = 5 après la greffe). Les participants avaient en moyenne 65.5 ± 8.8 ans. Quatre thèmes interreliés ont été dégagés : (1) la sensibilisation et la compréhension des patients quant à leur situation ou au contexte; (2) le besoin d’information; (3) le besoin d’un congé de dialyze; et (4) la confiance envers le médecin. La transparence, la clarté, la normalization et l’autonomie ont été jugées comme des sous-thèmes importants de l’éducation des participants. Pour la majorité des participants en attente d’une greffe (n = 8/10), l’idée d’un congé de 3 à 5 ans de dialyze rendrait acceptables les risques associés à l’acceptation d’un rein moins idéal.Étude tenue dans deux provinces canadiennes, ce qui limite la généralisabilité des résultats. Homogénéité des participants sur le plan démographique, notamment en ce qui concerne l’origine ethnique.Les résultats indiquent que les patients seraient à l’aise d’accepter un rein moins idéal pour une greffe, pourvu que leur autonomie soit respectée, qu’ils reçoivent des informations claires, standardisées et transparentes, et qu’ils aient confiance en leur médecin. Ces résultats serviront à éclairer l’élaboration d’un nouveau registre national afin d’élargir l’accès à la transplantation de rein provenant de donneurs décédés.Non enregistré.

BACKGROUND Despite the lack of evidence on the use of cannabis for the treatment of attention-deficit/hyperactivity disorder (ADHD), the growing perception that cannabis is safe has led more patients and caregivers to self-medicate. Some psychiatrists now authorize medicinal cannabis for patients with ADHD with features of oppositional defiant disorder (ODD) to curtail the unregulated (ie, self-medicated) use of recreational cannabis or to offer a therapeutic option to those who continue to experience symptoms after exhausting all other treatment options. OBJECTIVE This protocol aims to explore the perceived effectiveness and pharmacokinetics of cannabis in youth and young adults, who are currently taking it as part of their treatment plan for ADHD with features of ODD, under the supervision of a psychiatrist. METHODS Patients between the ages of 12 and 25 years with a diagnosis of ADHD and features of ODD, who are currently taking cannabis herbal extract (at a Δ9-tetrahydrocannabinol [THC]:cannabidiol [CBD] ratio of 1:20) as a treatment adjunct to stimulant pharmacotherapy will be recruited. A sample size of 10-20 individuals is estimated. The study interview will consist of (1) validated symptom rating scales (Swanson, Nolan, and Pelham-IV Questionnaire [SNAP-IV], 90-item; Patient Health Questionnaire, 9-item [PHQ-9]; and Screen for Child Anxiety Related Emotional Disorders [SCARED] tool to measure symptoms of ADHD and ODD, depression, and anxiety, respectively); (2) a semistructured interview to probe the experiences of using cannabis; and (3) a cannabis side effects survey. A cannabis product sample as well as 2 blood samples (a trough level and 2-hour postdose level) will be collected to measure plasma concentrations of cannabinoids and relevant metabolites (THC, CBD, 11-hydroxy-THC, 7-hydroxy-CBD, cannabichromene, and 11-nor-9-carboxy-THB) using liquid chromatography–tandem mass spectrometry (LC–MS/MS). Self-report rating scales (SNAP-IV, SCARED, and PHQ-9) will be scored in accordance with standard protocols and compared to retrospective scores obtained from the participant’s chart. Demographic variables (age, weight, and race), symptom scores, and blood levels (peaks and troughs) of THC, CBD, cannabichromene (CBC), and metabolites will be summarized using descriptive statistics. Relationships between plasma concentrations and symptom scores will be determined using analysis of variance, and multiple regression analysis will be performed to determine associations between plasma concentrations and demographic variables (age, weight, and ethnicity). The qualitative data will be audio-recorded and transcribed and organized into themes. RESULTS The protocol was approved by the Biomedical Research Ethics Board at the University of Saskatchewan (protocol #1726), and recruitment began in May 2021. CONCLUSIONS This proof-of-concept study will explore the potential treatment effectiveness of medical cannabis in participants with ADHD and ODD through a mixed methods approach to inform future research in this area. CLINICALTRIAL INTERNATIONAL REGISTERED REPORT DERR1-10.2196/31281

Experiential education is a critical component of any pharmacy undergraduate curriculum. Establishing new, high-quality practice sites can be challenging. We designed a new advanced pharmacy practice experiential rotation suitable for implementation in most community pharmacy settings. The aim of this article is to describe the design of this rotation entitled the Targeted Pharmacy Intervention in Inflammatory Bowel Disease (TPI-IBD) and to determine its impact on student knowledge and confidence using a before-after survey design. The TPI-IBD utilizes a student-delivered intervention as a platform for experiential learning in community pharmacy practice. The TPI was focused on patients with IBD, and implementation was guided by a co-preceptor from the university in collaboration with onsite-preceptors at each pharmacy. The TPI-IBD rotation was delivered from 6 community pharmacies during 5 weeks in 2018. Students conducted standardized monitoring on patients with IBD and met weekly with the university preceptor for case presentations and therapeutic discussions. Electronic charts were maintained by students who were responsible for ensuring detailed documentation on each patient. Knowledge, confidence, and overall satisfaction were assessed by a survey given to students before and after the rotation. Students were highly satisfied with the learning experience and improvements in knowledge and confidence were clearly demonstrated. The TPI strategy was an effective way to expand rotation options in community pharmacy sites with minimal burden on local preceptors.

The Saskatchewan Medication Assessment Program (SMAP) compensates community pharmacists for medication reviews on eligible residents with the goal of optimizing patient care. Although medication reviews are meant to reduce risks associated with complex medication regimens, some patients may already be receiving specialized care from interdisciplinary health care teams from the renal programs in Saskatchewan.A qualitative analysis was undertaken to examine the perceptions of health care providers about the SMAP process for patients receiving renal care in Saskatchewan. The goal was to explore potential benefits, facilitators, challenges, and/or barriers of the program in this population.Qualitative descriptive study.The semi-structured interviews took place in the province of Saskatchewan.Community pharmacists, renal pharmacist, and nephrologists.All nephrologists, renal pharmacists, and community pharmacies in Saskatoon and Regina were sent an invitation to participate in the study. Semi-structured interviews were completed with participants and were audio-recorded and transcribed verbatim. Coding was performed using NVIVO qualitative software, and meaning units and codes were consolidated into categories and subcategories using qualitative content analysis.A total of 9 community pharmacists, 10 renal pharmacists, and 8 nephrologists were interviewed. Community pharmacists had mixed levels of comfort providing SMAP assessments for renal patients, but expressed the desire to provide the best care possible and described patient benefits. Some categories (eg, barriers and improvements) and subcategories (eg, "collaboration/communication", "other challenges," and "suggestions for improvement") were consistent among all participant groups, while others (eg, "renal patients have complex care needs" and "duplication of service") were common among both renal pharmacists and nephrologists. The nephrologists had little knowledge of the program and of the role of the community pharmacist, indicating the need for improved education and communication.The lack of renal patient perceptions on the SMAP process should be acknowledged and studied in future. A further limitation is the small sample size per subsample group.Despite some negative experiences, all of the participants believed the program can be beneficial. However, several recommendations were suggested to improve the SMAP process in renal patients and other complex patient populations.Dans le but d’optimiser les soins aux patients, leUne analyse qualitative a été menée pour examiner la perception des fournisseurs de soins en regard du processus SMAP pour les patients recevant des soins de santé rénale en Saskatchewan. L’objectif était d’explorer les potentiels bienfaits, facilitateurs, défis et/ou obstacles du programme pour cette population.Étude qualitative et descriptive.Entretiens semi-structurés s’étant tenus dans la province de la Saskatchewan.Des pharmaciens communautaires, des pharmaciens spécialisés en néphrologie et des néphrologues.Tous les néphrologues, pharmaciens spécialisés en néphrologie et pharmaciens communautaires de Régina et de Saskatoon ont été invités à participer à l’étude. Des entretiens semi-structurés ont été menés auprès des participants. Les entretiens ont été enregistrés puis transcrits verbatim. Le logiciel d’analyse qualitative NVIVO a servi au codage; les unités et codes de signification ont été regroupés en catégories et sous-catégories à l’aide de l’analyse qualitative de contenu.Neuf pharmaciens communautaires, dix pharmaciens spécialisés en néphrologie et huit néphrologues ont été interviewés. Les pharmaciens communautaires étaient plus ou moins confortables à l’idée de faire les évaluations du SMAP pour les patients atteints de néphropathies, mais ont exprimé le souhait d’en décrire les avantages aux patients et de fournir les meilleurs soins que possible. Certaines catégories (obstacles et améliorations) et sous-catégories (collaboration/communication, « autres défis » et « suggestions d’améliorations ») étaient cohérentes entre les groupes, alors que d’autres (« les patients atteints de néphropathies ont des besoins complexes » ou « dédoublement des services ») étaient fréquentes pour les néphrologues et les pharmaciens spécialisés en néphrologie. Les néphrologues en savaient très peu sur le programme et sur le rôle des pharmaciens communautaires, ce qui souligne la nécessité d’améliorer la sensibilisation et la communication.La perception des patients en regard du SMAP devrait être reconnue et étudiée dans de futurs essais. Aussi, le faible échantillon de chacun des sous-groupes de participants limite les résultats.Malgré quelques expériences négatives, tous les participants ont jugé que le programme peut être bénéfique. Plusieurs recommandations ont été avancées pour améliorer le processus du SMAP pour les patients atteints de néphropathies et pour d’autres populations de cas complexes.Sans objet.

Introduction: Providing support throughout the lung transplant process is an intensive task, which requires a dedicated caregiver. The needs of caregivers who must relocate with their loved one receiving the transplant are currently unknown. The objective of this study is to explore experiences and perceptions of lung transplant caregivers identified from a satellite clinic to inform the development of educational resources. Methods: A qualitative study with a phenomenology approach was undertaken with individuals who have taken on the role of a caregiver for lung transplant candidates or recipients and must travel to the specialized transplant center. Semistructured interviews were conducted with 12 caregivers. Interviews conducted by phone were audio-recorded and then transcribed verbatim. NVivo software was used to code the data and identify emerging themes. Results: Ideas were classified into the following 4 themes: (1) the stress of being a caregiver, (2) caregivers undertake a variety of roles, (3) caregivers require support, and (4) satisfaction with health care providers. Even though the caregivers lived an average of 7.1 (standard deviation 2) hours from the surgical transplant center, all expressed satisfaction with the level of care that they received. Caregivers identified several stressors during the transplant process and described various strategies for coping. Conclusion: Caregivers shared their experiences on the transplant process. It was evident that being a caregiver was a stressful and supports were necessary for those undertaking this role. These insights will help inform the development of a new educational resource for patients and caregivers.

Interprofessional education (IPE) is increasingly utilized to prepare students for their future careers in the health sciences as collaborative practitioners. Although it is considered an accreditation requirement in most health science disciplines, little is known about first year student's perceptions of IPE in Canada. In September of 2018, students from dentistry, kinesiology, medicine, nursing, nutrition, pharmacy, and physiotherapy in their first year of their professional program at the University of Saskatchewan were surveyed to obtain a baseline of perspectives and attitudes toward IPE. The survey consisted of an adaptation of the Readiness for Interprofessional Learning Scale (RIPLS) and additional questions to assess students' skills and interest in IPE. Descriptive and univariate statistics were used to determine associations with demographic variables. The response rate was 88% (

RATIONALE: Poor inhaler technique is a pervasive problem among patients with chronic respiratory conditions. It has been associated with inadequate drug delivery and poor respiratory outcom...

Background Inadequate patient knowledge about transplantation can result in low patient satisfaction and contribute to poor clinical outcomes. The purpose of this patient-oriented research project was to develop an educational intervention for patients awaiting kidney transplantation. Methods An educational intervention was developed by patients and health care providers, experts in medication adherence, video education, motivational psychology, and cultural education. Project objectives were defined and content was guided by a series of studies conducted with stakeholders. A review process was undertaken with additional patients, external health care providers and ninth grade high school students and edits were applied accordingly. Results A set of six educational videos, ranging in length from 3 to 24 min, was created to describe the transplant process. The videos are patient friendly in design, and incorporate animations to explain complex information to accommodate low health literacy, and patient testimonials align the content with principles of adult learning theory. Feedback from external patient reviews [n = 8], external care providers [n = 13] and students [n = 26], indicate that the mini-series is informative and useful. Conclusion Patient involvement significantly influenced the development of a video series about kidney transplantation. Practice Implications: Patient engagement is integral for developing high quality and relevant educational interventions.

BackgroundDespite the lack of evidence on the use of cannabis for the treatment of attention-deficit/hyperactivity disorder (ADHD), the growing perception that cannabis is safe has led more patients and caregivers to self-medicate. Some psychiatrists now authorize medicinal cannabis for patients with ADHD with features of oppositional defiant disorder (ODD) to curtail the unregulated (ie, self-medicated) use of recreational cannabis or to offer a therapeutic option to those who continue to experience symptoms after exhausting all other treatment options.ObjectiveThis protocol aims to explore the perceived effectiveness and pharmacokinetics of cannabis in youth and young adults, who are currently taking it as part of their treatment plan for ADHD with features of ODD, under the supervision of a psychiatrist.MethodsPatients between the ages of 12 and 25 years with a diagnosis of ADHD and features of ODD, who are currently taking cannabis herbal extract (at a Δ9-tetrahydrocannabinol [THC]:cannabidiol [CBD] ratio of 1:20) as a treatment adjunct to stimulant pharmacotherapy will be recruited. A sample size of 10-20 individuals is estimated. The study interview will consist of (1) validated symptom rating scales (Swanson, Nolan, and Pelham-IV Questionnaire [SNAP-IV], 90-item; Patient Health Questionnaire, 9-item [PHQ-9]; and Screen for Child Anxiety Related Emotional Disorders [SCARED] tool to measure symptoms of ADHD and ODD, depression, and anxiety, respectively); (2) a semistructured interview to probe the experiences of using cannabis; and (3) a cannabis side effects survey. A cannabis product sample as well as 2 blood samples (a trough level and 2-hour postdose level) will be collected to measure plasma concentrations of cannabinoids and relevant metabolites (THC, CBD, 11-hydroxy-THC, 7-hydroxy-CBD, cannabichromene, and 11-nor-9-carboxy-THB) using liquid chromatography–tandem mass spectrometry (LC–MS/MS). Self-report rating scales (SNAP-IV, SCARED, and PHQ-9) will be scored in accordance with standard protocols and compared to retrospective scores obtained from the participant’s chart. Demographic variables (age, weight, and race), symptom scores, and blood levels (peaks and troughs) of THC, CBD, cannabichromene (CBC), and metabolites will be summarized using descriptive statistics. Relationships between plasma concentrations and symptom scores will be determined using analysis of variance, and multiple regression analysis will be performed to determine associations between plasma concentrations and demographic variables (age, weight, and ethnicity). The qualitative data will be audio-recorded and transcribed and organized into themes.ResultsThe protocol was approved by the Biomedical Research Ethics Board at the University of Saskatchewan (protocol #1726), and recruitment began in May 2021.ConclusionsThis proof-of-concept study will explore the potential treatment effectiveness of medical cannabis in participants with ADHD and ODD through a mixed methods approach to inform future research in this area.International Registered Report Identifier (IRRID)DERR1-10.2196/31281

Context: Poor knowledge about immunosuppressive (IS) medications remains a major problem for patients in the posttransplant setting. Therefore, more effective educational strategies in the pretransplant setting are being considered as a possible method to improve knowledge and readiness for the challenges of posttransplant care. However, the most effective/relevant content of a pretransplant educational program is yet to be determined. Objective: To identify pretransplant education topics from the posttransplant patient perspective. Design: A focus group meeting was conducted among 7 high-functioning, stable adult kidney transplant recipients recruited from the Saskatchewan Transplant Program. Demographic information including age, gender, occupation, background/ethnicity, and time since transplant were recorded. A moderator, assistant moderator, and research assistant facilitated the 90-minute focus group meeting using a predetermined semistructured interview guide. The session was audio recorded and transcribed verbatim. Nvivo software was used to code the data and identify emerging themes exploring views of participants relating to the educational information required for pretransplant patients. Results: Patients were satisfied with the education they had received. Ideas were classified into the following major themes—patient satisfaction, transplant waitlist, surgery, medications, posttransplant complications, lifestyle and monitoring, knowledge acquisition, illusion of control, and life changes posttransplant. Knowledge gaps were identified in all areas of the transplantation process and were not exclusive to IS medications. Conclusion: Misconceptions regarding transplantation were identified by a group of high-functioning, stable adult recipients who were satisfied with their clinical care. Future educational strategies should aim to address the entire transplantation process and not be limited to medications.

Background: Because cannabis use in children can have negative consequences, the recent legalization of recreational cannabis for adults in Canada creates an urgent need for youth education. Method: A multidisciplinary clinical rotation was developed wherein nursing and pharmacy students collaborated with youth (grades 7 through 10) to construct an educational program about cannabis. Four schools participated, representing a variety of socioeconomic demographics. Feedback was solicited from students and stakeholders. The purpose of this project was to create REACH ( R eal E ducation A bout C annabis and H ealth), a toolkit and curriculum resource that includes lesson plans for teachers covering the science of cannabis, social science implications, peer pressure, decision making and harm reduction, videos featuring youth testimonials, and supplemental resources. Results: Preliminary feedback suggests the materials are engaging and informative. Conclusion: A collaboration of health science students with youth in schools resulted in an authentic and relatable educational program about cannabis. Future studies will evaluate REACH's effectiveness in seventh- and ninth-grade students. [ J Nurs Educ . 2020;59(8):465–469.]

Background In 2014 and 2015, biosimilars for the drugs filgrastim, infliximab, and insulin glargine were approved for use in Canada. The introduction of biosimilars in Canada could provide significant cost savings for the Canadian healthcare system over originator biologic drugs, however it is known that the use of biosimilars varies widely across the world. The aim of this study was to estimate the use of biosimilars in Canada and potential cost-savings from their use. Methods We performed a retrospective analysis of Canadian drug purchases for filgrastim, infliximab, and insulin glargine from July 2016 to June 2018. This was a cross-sectional study and the time horizon was limited to the study period. As a result, no discounting of effects over time was included. Canadian drugstore and hospital purchases data, obtained from IQVIA™, were used to estimate the costs per unit and unit volume for biosimilars and originator biologic drugs within each province. Potential cost-savings were calculated as a product of the units of reference originator product purchased and the cost difference between the originator biologic and its corresponding biosimilar. Results The purchase of biosimilars varied by each province in Canada, ranging from a low of 0.1% to a high of 81.6% of purchases. In total, $1,048,663,876 Canadian dollars in savings could have been realized with 100% use of biosimilars over the originator products during this 2 year time period. The potential savings are highest in the province of Ontario ($349 million); however, even in smaller markets (PEI and Newfoundland), $28 million could have potentially been saved. Infliximab accounted for the vast majority of the potential cost-savings, whereas the purchases of the biosimilar filgrastim outpaced that of the originator drug in some provinces. In sensitivity analyses assuming only 80% of originator units would be eligible for use as a biosimilar, $838 million dollars in cost savings over this two-year time period would still have been realized. Conclusions The overall use of biosimilar drugs in Canada is low. Policy makers, healthcare providers, and patients need to be informed of potential savings by increased use of biosimilars, particularly in an increasingly costly healthcare system.

IntroductionNon-adherence after kidney transplantation contributes to increased rejections, hospitalisations and healthcare expenditures. Although effective adherence interventions are sorely needed, increasing education and support to transplant recipients demands greater use of care providers’ time and resources in a healthcare system that is stretched. The objective of this clinical trial is to determine the effectiveness of an electronically delivered video series and adherence behaviour contract on improving medication adherence to immunosuppressant medications.Methods and analysisA multicentre, parallel arm, randomised controlled trial will be conducted with four sites across North America (Saskatoon, Calgary, Halifax, Chicago). Adult patients will be randomised (1:1) to either the intervention (ie, home-based video education +behaviour contract plus usual care) or usual care alone. De novo transplant recipients will be enrolled prior to their hospital discharge and will be provided with electronic access to the video intervention (immediately) and adherence contract (1 month post-transplant). Follow-up electronic surveys will be provided at 3 and 12 months postenrolment. The primary outcome will be adherence at 12 months post-transplant, as measured by self-report Basel Assessment of Adherence to Immunosuppressive medications and immunosuppressant levels. Secondary outcomes include the difference in knowledge score between the intervention and control in groups (measured by the Kidney Transplant Understanding Tool); differences in self-efficacy (Generalised Self-efficacy Scale), Beliefs of Medicine Questionnaire (BMQ), quality of life (Short Form-12), patient satisfaction and cost utilisation. The study aims to recruit at least 200 participants across participating sites.Ethics and disseminationEthical approval was obtained from the University of Saskatchewan Behavioural Ethics Committee (Beh 18–63), and all patients provide informed consent prior to participating. This educational intervention aims to improve information retention and self-efficacy, leading to improved medication adherence after kidney transplantation, at low cost, with little impact to existing healthcare personnel. If proven beneficial, delivery can be easily implemented into standard of care.Trial registration numberNCT03540121; Pre-results.

Context:Adequate patient education is essential for preparing potential recipients for kidney transplantation. Health-care providers play a vital role in education and can identify gaps in patient understanding.Objective:To identify deficits in patient knowledge from the perspective of a transplant multidisciplinary care team and determine whether their perceptions align with patients who have previously undergone a transplant.Design:An open call was advertised for health-care providers to attend a focus group discussion regarding the educational needs of pretransplant patients in 1 Canadian center. A predetermined, semistructured set of questions was used to collect the views of transplant caregivers. A moderator, assistant moderator, and research assistant facilitated the discussion, which was transcribed verbatim. Paper surveys were distributed to collect opinions of those unable to attend or uncomfortable to voice their opinion in an open forum. Qualitative analysis software was used to identify any emergent themes. Results were compared to a previous study undertaken in transplant recipients.Results:Despite pre- and posttransplant education, specific themes emerged including misconceptions about the assessment process and time on the wait list and the surgery, incongruency between patient expectations and outcome, and confusion regarding medications. Health-care provider perceptions were remarkably consistent with transplant recipients.Conclusion:Health-care providers identified gaps in patient understanding indicating that transplant candidates may not be internalizing what is taught. Innovative educational approaches may be needed to provide more successful patient education. Similarities between health-care provider and patient perceptions suggest that care providers are a valuable source of information.

Objective To determine the impact of the SIMPL-SYNC refill synchronization (SSRS) service compared with that of usual care (UC) on medication adherence when applied as an opt-out strategy among patients receiving chronic medications. Design This was a pragmatic randomized controlled trial. Setting and participants The study was conducted in 2 community pharmacies located in Saskatchewan, Canada. Eligible patients were chronic medication users visiting the study pharmacies. Outcome measures The primary outcome was the percentage of individuals achieving optimal adherence to all eligible study medications. Eligible study medications included 22 commonly used medication classes used to treat diverse conditions. Adherence was assessed for each medication class after 300 days using the proportion of days covered (PDC). Optimal adherence was defined as PDC ≥ 80%. Results A total of 488 patients were screened for eligibility, and 190 patients were included in the intention-to-treat analysis (95 in SSRS, 95 in UC). The mean age of participants was 59 years, and 34% (65/190) were older than 65 years. A total of 574 individual adherence observations representing the 22 eligible study medication classes were generated from the 190 study participants. The percentage of individuals achieving optimal adherence to all their eligible study medications was 50.5% (48/95) in the SSRS group versus 44.2% (42/95) in the UC group (P = 0.383). Similarly, no statistically significant difference was observed in a per-protocol analysis assessing people who participated fully in the service; the percentage of individuals achieving optimal adherence to all their eligible study medications was 55.1% (38/69) in SSRS versus 40.7% (33/81) in UC (P = 0.080). Patient refusal of the refill synchronization services was common among randomized patients. Conclusion SSRS service failed to detect a robust improvement in medication adherence when delivered using an opt-out strategy. However, small improvements in adherence or benefits to specific subgroups of patients could not be ruled out.

BackgroundHandover of care is one of the most perilous procedures in medicine.1The unique shift-based work in the ED, where there is a high degree of patient turnover, unpredictability and patient volume can create challenges to good quality clinician and nursing handover.The above highlights a need for an improved and standardised patient bedside handover tool for both clinicians and nurses involving and empowering patients and families. Both handover tools will cement safe continuity of information between shift changes and improved communication with patients and families.Method and resultsA standard operating procedure, flowchart and clinician’s handover tool was designed to maximise safe handover as illustrated in figure 1. The tool has been introduced into the department since June 2017. After the introduction of the tool, an evaluation survey of 30 participants across various grades of clinicians was performed.Abstract 001 Figure 1Clinicians handover toolBuilding on the success of the clinician’s handover tool; a standard operating procedure, flowchart and the first standardised nurse’s handover tool was designed as illustrated in figure 2.Abstract 001 Figure 2Nurses handover toolConclusionsFor the month of September 2017, 30 completed surveys evaluating the clinician’s handover tool was collected. 100% positive responses were received stating they found it useful. The handing over clinicians commented feeling more satisfied that ‘their patient was appropriately and safely handed over at the bed side in front of the family’.The nurse’s handover over tool was praised as nurses felt ‘happier’ with handover and more satisfied to leave shift ‘without forgetting significant patient information’.Both tools have become routine practice within the ED and are very useful adjuncts to improve patient safety within the department.Multidisciplinary handover post-shift work at the bedside has become standardised practice and improved patient safety with continuity of care with these tools. Regular ongoing audit have demonstrated that the tools are routinely used by both clinicians and nurses.ReferenceBritish Medical Association. Safe handover: safe patients. Guidance on clinical handover for clinicans and managers. London: BMA, 2004.

High-dose or “pulse” corticosteroid therapy is used to treat a vast array of conditions. There is considerable evidence for their use in musculoskeletal diseases, such as rheumatoid arthritis, as well as dermatological diseases, such as psoriasis. They are also used in the treatment of a variety of other conditions, including some renal, hematological, ophthalmic, neurological, nephrological, pulmonary, gastrointestinal and neoplastic diseases. Pulse therapy typically refers to the administration of more than 250 mg prednisone (or equivalent) per day in an intermittent fashion to enhance the therapeutic effect and lessen the long-term adverse effects.1 Although the association between bradycardia and high-dose corticosteroids was first documented in 1986,2 it is not a commonly reported adverse effect.1 Cardiac arrhythmias have been reported to occur in 1% to 82% of patients receiving high doses of corticosteroids.3,4 These adverse effects, which include atrial fibrillation/flutter, ventricular tachycardias and sinus bradycardia,5 are usually associated with the intravenous route of administration. New reports have emerged, however, indicating that oral pulse steroids have a similar risk of inducing bradycardia and other arrhythmias.5-7 This is of significance because the oral route of administration is becoming increasingly more common due to the improved patient convenience and cost and similar efficacy.1 In this report, we describe a patient who developed bradycardia after receiving a course of oral corticosteroids for the treatment of a multiple sclerosis exacerbation. We hope that this case serves as a reminder of the critical role that pharmacists can play in preventing and monitoring for corticosteroid-induced bradycardia.

Improved health care collaboration has been cited as a key strategy for health care reform.1,2 Collaboration in health care has been shown to improve patient outcomes such as reducing preventable adverse drug reactions,3,4 decreasing morbidity and mortality rates5,6 and optimizing medication dosages.7 Teamwork has also been shown to provide benefits to health care providers, including reducing extra work4 and increasing job satisfaction.8 As a fourth-year pharmacy student at the University of Saskatchewan (BB), I have noticed this shift becoming increasingly evident in our education, with the incorporation of interprofessional-based learning activities and relocation to a recently built health sciences building. Having played competitive hockey for about 15 years, I have been on both highly successful teams that went on to win championships, as well as teams that were unable to function effectively. What was it about these teams that contributed to our successes or failures? Moreover, can these lessons be extrapolated to health care teams? Characteristics have been identified in both sports and health care that may influence team success.2,9 Examples include accountability, communication, leadership, discipline, coordination, having a clear purpose and having a strategy in place. While a cooking recipe may consist of many ingredients (some perhaps to add flavour; others for consistency), a few ingredients will always remain essential. Reflecting on my experiences as an athlete and as a pharmacy student, 5 key ingredients seem necessary for success in a collaborative team (Table 1). Table 1 Five essential ingredients for team success

Background/Aims: The 7-year Major Adverse Cardiovascular Events Calculator (CRCRTR-MACE) predicts cardiovascular events (CVE) in renal transplant recipients (RTR), and thrombopoietin (TPO) is a humoral inflammatory factor implicated in cardiovascular disease (CVD). The aim of the study was to determine if circulating TPO levels in stable RTR are positively associated with variable(s) in the CRCRTR-MACE score. Methods: CRCRTR-MACE scores were calculated in 95 stable RTR. TPO levels were measured by multiplexed fluorescent bead-based immunoassay in all patients and 48 controls. Multivariate analysis (MVA) was performed between TPO and CV risk variables and patient demographics. Stepwise regression with backward elimination of insignificant variables estimated the impact of risk variables on TPO levels. Significance was defined at p < 0.05. Normalized data were presented as mean ± SD and non-normalized data as median (maximum to minimum). Results: The risk of a CVE within 7 years as predicted by the median was 9.97% (range 1.93-84.2). The percentage of patients who were above 20% risk for a CVE was 28.4%. Control TPO level of 170.41 (4.4-995.9) pg/ml was significantly lower than that of 237.90 (32.77-1,386.79) pg/ml in RTR (p = 0.010). TPO level correlated significantly with the total CRCRTR-MACE score (R = 0.310, p = 0.004), smoking (p = 0.009) and eGFR (R = -0.275, p = 0.012) but not with age, diabetes, LDL level or history of CVE. Only the total CRCRTR-MACE score (p = 0.013) and smoking (p = 0.009) remained significant in the MVA. Stepwise regression estimated that smoking increased TPO levels by 206.28 pg/ml and each 10% increase in CRCRTR-MACE score increased TPO levels by an additional 44.4 pg/ml. Conclusion: TPO levels are increased in RTR with high CRCRTR-MACE, particularly in smokers with diminished eGFR. Circulating TPO may serve as a biomarker and treatment target for CVD in RTR.

Poor knowledge about immunosuppressive (IS) medications remains a major problem for patients in the posttransplant setting. Therefore, more effective educational strategies in the pretransplant setting are being considered as a possible method to improve knowledge and readiness for the challenges of posttransplant care. However, the most effective/relevant content of a pretransplant educational program is yet to be determined.To identify pretransplant education topics from the posttransplant patient perspective.A focus group meeting was conducted among 7 high-functioning, stable adult kidney transplant recipients recruited from the Saskatchewan Transplant Program. Demographic information including age, gender, occupation, background/ethnicity, and time since transplant were recorded. A moderator, assistant moderator, and research assistant facilitated the 90-minute focus group meeting using a predetermined semistructured interview guide. The session was audio recorded and transcribed verbatim. Nvivo software was used to code the data and identify emerging themes exploring views of participants relating to the educational information required for pretransplant patients.Patients were satisfied with the education they had received. Ideas were classified into the following major themes-patient satisfaction, transplant waitlist, surgery, medications, posttransplant complications, lifestyle and monitoring, knowledge acquisition, illusion of control, and life changes posttransplant. Knowledge gaps were identified in all areas of the transplantation process and were not exclusive to IS medications.Misconceptions regarding transplantation were identified by a group of high-functioning, stable adult recipients who were satisfied with their clinical care. Future educational strategies should aim to address the entire transplantation process and not be limited to medications.

Adverse symptoms of immunosuppressants (ASI) impact quality of life (QOL) in solid organ transplant recipients; however, standardized approaches for active ASI surveillance and intervention are lacking. While management is highly clinician dependent, clinician views remain largely unexplored. We surveyed Canadian Society of Transplantation members on their perceptions of ASI including frequency, perceived QOL impact, causal attribution, management strategies, and success. Sixty-one clinicians participated in the survey of 12 ASI (tremor, diarrhea, nausea, constipation, dyspepsia, insomnia, edema, dyspnea, arthralgia, acne, mouth sores, paresthesias), for a 22% response rate. Forty-nine completed the survey (80% completion rate). Diarrhea, dyspepsia, and insomnia were most frequent, requiring management in ≥ 2% of patients by 96%, 90%, and 82% of respondents, respectively. Diarrhea, insomnia, and dyspnea were deemed to have an important QOL impact by 92%, 82%, and 69%. Immunosuppressants were universally implicated as causative of tremor, diarrhea, acne, and mouth sores. Over 80% reported success in managing mouth sores, dyspepsia, and constipation. Management strategies included adjustment of immunosuppressant or other medications, drug therapy, and nonpharmacologic approaches and varied according to perceived causal attribution. More study is needed to compare clinician and patient views. These results will be used to establish priorities for further investigation of ASI.

Background: Filgrastim was first introduced to the Canadian marketplace as Neupogen® in 1992 to treat neutropenia caused by chemotherapy regimens. In 2009, the first biosimilar drug was approved for use in Canada, and in March 2016, a biosimilar for filgrastim (Grastofil®) became available. Biosimilars represent safe, effective, and cost effective alternatives to originator biologic medications. However, although biosimilar medications present opportunities for significant cost savings to the health care system, overall uptake and use of biosimilar medications in North America has been low. The aim of this study was to describe the overall use of the filgrastim products Grastofil® and Neupogen® in Canada. Methods: A retrospective analysis of Canadian drug purchases between July 2016 and June 2018 was performed for the drug filgrastim (Neupogen®, Grastofil®). The data used to estimate drug purchases were obtained from IQVIA™, a multi-national healthcare analytics company. Samples from the IQVIA™ Canadian Drugstore and Hospital Purchases (CDH) audit covered greater than 88% of the hospital market and one-third of the retail market. Samples were stratified by region, market size, and type of outlet (e.g. cancer centers, long-term care). For each drug, the total purchase dollar amounts were provided by province on a month by month basis. Potential cost-savings were calculated as a product between the units of each product purchased and the cost difference between Neupogen® and the biosimilar Grastofil® on a quarterly basis for each province. Results: Between July 1st, 2016 and June 30th, 2018, Grastofil® accounted for 27.0% (382,254/1,415,762 units) of filgrastim purchases. During this time period, $62,061,576 was spent on Grastofil® purchases and $204,152,590 was spent on Neupogen® purchases. Through use of the biosimilar Grastofil®, $13,443,873 (37.0%) in savings were realized. Had there been 100% use of the biosimilar Grastofil®, it would have resulted in $36,348,476 in cost savings. In the first quarter (July to September 2016) Grastofil® accounted for 1.5% of filgrastim purchases, whereas in the April to June 2018 quarter it increased to 43.6% of filgrastim purchases. The overall percentage of filgrastim units purchased by Canadian province varied substantially. The market share captured by Grastofil® ranged from a low of 0.08% ($4007/$5,189,623) in the province of Nova Scotia, to a high of 81.62% ($932,864/$1,142,905) in the province of Saskatchewan. Canada's largest province, Ontario, saw Grastofil® account for 44.7% ($9,047,489/$20,229,421) of purchases during this time period. Discussion: Although the biosimilar Grastofil® only accounted for 27% of filgrastim purchases between 2016 and 2018, there was substantial growth over this time period. By the end of June 2018, Grastofil® accounted for approximately 44% of filgrastim purchases, which is substantially higher than other biosimilar medications currently available in Canada. There are also stark differences between each province, whereas some had little to no use of the biosimilar, whereby in other provinces the purchases of Grastofil® outnumbered the purchases of Neupogen®. Had there been exclusive use of the biosimilar, an additional $23 million dollars in savings could have been realized. Conclusions: The use of biosimilars represents an opportunity for cost savings to be realized in an over-extended health care system. Although there appears to be acceptance for the use of Grastofil® as the overall purchases trended up from 2016 to 2018, there are still significant cost savings that could be realized by greater use of biosimilar drugs. Disclosures Mansell: Apobiologix: Research Funding.

BACKGROUND Several educational interventions have been designed to improve patient knowledge before and after kidney transplantation. However, evaluation of such interventions has been difficult because validated instruments to measure knowledge-based outcomes in this population have not been developed. OBJECTIVE To create a tool to measure patient knowledge of kidney transplantation and to evaluate its validity. METHODS The Kidney Transplant Understanding Tool (K-TUT) was created using a stepwise iterative process. Experts in the field and transplant recipients were consulted to establish content validity. The K-TUT consists of 9 true/false and 13 multiple-choice questions, and scores are based on the number correct answers [YES/NO format] of 69 items. The questionnaire was piloted in a study that also measured health literacy (via the Short Test of Functional Health Literacy) in transplant candidates, whereas the main survey was mailed to transplant recipients. Test-retest was performed, and completed surveys were analyzed for internal consistency, construct validity, floor and ceiling effects, and reproducibility. RESULTS Surveys were offered to 106 pretransplant patients and 235 in the posttransplant period, and response rates were 38.7% (41/106) and 63.4% (149/235), respectively. The mean corrected scores were 53.1 ± 8.5 (77%) and 56.2 ± 6.3 (81%), respectively. Test-retest was performed over 20% of both cohorts and percent agreement ranged between 70% and 100% in the pretransplant group and 66% and 100% in the posttransplant group. Cronbach α ranged from 0.794 to 0.875 in all cohorts indicating favorable internal consistency. Increased health literacy in the pretransplant group was significantly associated with increased knowledge (r = 0.52; P < 0.001), suggestive of construct validity, and the absence of floor and ceiling effects was positive. The majority of transplant recipients (98/148, 67%) believed the questionnaire adequately assessed transplant knowledge, about a quarter (36/148, 24.3%) were "unsure," and 85% (126/148) agreed that no questions should be removed. CONCLUSIONS Although more study is warranted to further assess psychometric properties, the K-TUT appears to be a promising tool to measure transplant knowledge.

As the Canadian population continues to age, the incidence of cancer is on the rise. To help alleviate the burden malignancy imposes on our health care system, a shift toward early cancer detection is necessary. Pharmacists are well positioned and willing to assume a more active role in cancer surveillance. Patients are receptive to pharmacist involvement and seem to prefer a convenient community pharmacy–based location for screening programs. The community pharmacist’s current and potential role in cancer screening and prevention is summarized in this article. A review of screening recommendations and a discussion of opportunities will hopefully inspire pharmacists to consider incorporating malignancy screening initiatives into their practice.

Objective To determine the amount of diabetes content taught at Canadian schools of pharmacy, and students’ perceptions of diabetes education. Methods Between September 23 and October 23, 2015, faculty members at each pharmacy school were asked to provide the amount of didactic, interactive, and elective hours devoted to diabetes education. These faculty members subsequently emailed an electronic web-survey to all fourth year pharmacy students to ascertain their perceptions of the amount of diabetes-related material they received and comfort level pertaining to diabetes education. Results Representatives from each pharmacy school (10/10; 100%) reported the amount of diabetes education provided at their schools (range of 18–43.5 hours; mean 25.3 hours). Student responses were obtained from 90% (9/10) of pharmacy schools; a total of 313/1216 (25.7%) students completed the questionnaire. The majority of pharmacy students (53.2%; 166/313) reported feeling the overall amount of diabetes content in their curriculum was just right while 46.2% (144/313) felt there was too little. 95.6% (299/313) disagreed diabetes received too much attention in the curriculum. A post-hoc analysis revealed that students who attended schools with more contact hours or a diabetes-specific elective felt more comfortable with dealing with certain diabetes patients and situations. Conclusions Pharmacy schools vary in the amount of diabetes content taught in their curriculum. Students were split between feeling they received enough diabetes education or too little; students who received more content reported greater comfort in dealing with most diabetes patients and situations. This information is useful for pharmacy schools looking to evaluate their curricular diabetes content.