The Drug Program Information Network

Dec 22, 2020

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

My sister suggested we try to technologically get together over Christmas. My sister and her husband are in Langley, BC. My parents are in Pinawa, MB and my immediate family is in Dauphin. We asked if my parents, who are in their mid-seventies, thought they could handle Zoom. They said that they'd be fine. My parents have been playing a lot of cards with their friends over the internet during the pandemic. They play a lot of Bridge, a game I have never understood, but for the sake of the kids and grandkids they suggested we play some easy card games together. While my sister and I tried to agree on a time that everyone was available to Zoom, it occurred to me I didn't know if I have a deck of cards in my house. The last time I played cards was probably at my parent's house. That was a year and a half ago. Do cards count as essential items that I can buy at the store?

The Drug Program Information Network or DPIN is essential. DPIN is a computer network that links all the community pharmacies in Manitoba. This way if you fill one prescription in Winnipeg, one in Grandview and one Ste. Rose all these prescriptions are stored in one place at Manitoba Health. This helps your pharmacist catch interactions and duplications with prescriptions you filled at another pharmacy. It doesn't mean I can automatically fill a prescription you last had filled in Winnipeg, though. In fact, from your DPIN profile, I can't even see where you filled that other prescription. You still have to tell me where you filled it and the phone number of that pharmacy and then I can call them and get the prescription transferred.

DPIN is very useful to doctors in their offices and to nurses in the ER as well. If you, the patient, are unable to tell them what medications you are taking, they can look them up electronically. There are a few holes in the DPIN system, though. DPIN can't show compounds. Compounds are when the pharmacist mixes two or more ingredients together. All DPIN shows is "compound", not what is in it. DPIN can't show when you take your medications. DPIN can show you take 5 pills a day, but it can't show that you take 2 pills at breakfast, 1 pill at lunch and 2 pills at supper. And DPIN can't show if a medication was stopped. If your doctor gave you a blood pressure pills on Tuesday and on Thursday you and your doc decided it wasn't working, stopped it and started a different pill, on DPIN it would look like you were still on both blood pressure pills. As good as DPIN is, it is important to have a written list of your medications with you to show doctors and other health care professionals.

There are ways patients can unintentionally fool DPIN. Let's say a husband and wife, Bill and Mary, both take the same blood pressure medication. Whether for convenience, or to save money they decide to just fill Bill's prescription and both use meds from the same bottle. What harm could that do? Let's send Mary to the ER with chest pain. Mary is confused and unable to tell the ER doc what meds she is on. The ER doc has no idea the Bill and Mary are both using the same bottle of pills. The ER doc looks at DPIN thinks Mary is on no blood pressure meds. The ER doc might give Mary a medication that interacts badly with the prescription the doc doesn't know Mary is taking.

Like many things in healthcare, DPIN stops at the provincial border. Our new patient, Sam, has an eye condition. His family doc gives him an eye drop, but the condition doesn't get better. Sam is referred to an eye specialist in Yorkton, SK. The eye specialist decides to change the eye drops and writes Sam a prescription. Sam fills the prescription in Yorkton. A couple weeks later, Sam's eye is really sore and he goes to Walk-In. The Walk-In doc asks Sam what eye medication he is on. Sam says he can't remember. No problem, the Walk-In doc looks on DPIN. However, the Walk-In doc can only see the eye drop originally prescribed by the family doc that was filled in Manitoba. The Walk-In doc can't see the eye drop filled in Saskatchewan. Now the Walk-In doc has the wrong information on which to try to decide what is going on with Sam's eye.

The DPIN system is really helpful for keeping Manitobans safe and healthy. As a pharmacist, DPIN can help me catch when a specialist from Winnipeg prescribes a medication that will interfere with another prescription that a patient's family doctor has written. It helps an ER doc see what blood thinners an unresponsive patient is on. But as good as DPIN is, it is important to know it has limitations, so we don't unintentionally make our DPIN chart work against us. All members of your family should have their own prescriptions even if several family members use the same medication. Prescription medications filled out of province don't show up on the Manitoba DPIN system. And whether you write it out, or have your pharmacist help you, having a physical list of your medications on you is a really important safeguard for your health.

I found a deck of Dauphin Clinic Pharmacy playing cards in the basement. I thought I was set for the Zoom card game. Then the hamster wheel in my brain started spinning again. How do we play cards with three different decks? One in Langley, one in Pinawa, and one in Dauphin. Do we each divide the deck into 3 parts? Since 3 doesn't divide evenly into 52, do we throw out cards? And really, there are 4 people in Dauphin, 2 in Langley and 2 in Pinawa. Should we divide our decks into 8 equal chunks, one chunk per person? And what if the Ace of Diamonds ends up in the Langley chunk? Do I never get to see the Ace of Diamonds in Dauphin? My mind was twirling about how this freakishly complicated game was going to work. I called my parents, the online card experts, about all the intricacies of this upcoming game. I could hear the smiles on their faces over the phone. "No dear. We aren't going to use physical cards. We are all going to sign into a website. The cards are virtual. It's like we are all sitting in the same room using one deck of cards." And that is how my parents, in their mid-seventies, taught us all how to play virtual cards at Christmas.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional

As always if you have any questions or concerns about these or other products, ask your pharmacist.

 


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