Static outliers for NHS Ipswich And East Suffolk CCG

There is substantial variation in prescribing behaviours, across various different areas of medicine. Some variation can be explained by demographic changes, or local policies or guidelines, but much of the remaining variation is less easy to explain. At OpenPrescribing we are piloting a number of data-driven approaches to identify unusual prescribing and collect feedback on this prescribing to inform development of new tools to support prescribers and organisations to audit and review prescribing.

This report has been developed to automatically identify prescribing patterns at a chemical level which are furthest away from “typical prescribing” and can be classified as an “outlier”. We calculate the number of prescriptions for each chemical in the BNF coding system using the BNF subparagraph as a denominator, for prescriptions dispensed between April 2021 and August 2021. We then calculate the mean and standard deviation for each numerator and denominator pair across all practices/CCGs/PCNs/STPs. From this we can calculate the “z-score”, which is a measure of how many standard deviations a given practice/CCG/PCN/STP is from the population mean. We then rank your “z-scores” to find the top 5 results where prescribing is an outlier for prescribing higher than its peers and those where it is an outlier for prescribing lower than its peers.

It is important to remember that this information was generated automatically and it is therefore likely that some of the behaviour is warranted. This report seeks only to collect information about where this variation may be warranted and where it might not. Our full analytical method code is openly available on GitHub here.

The DataLab is keen to hear your feedback on the results. You can do this by completing the following survey or emailing us at ebmdatalab@phc.ox.ac.uk. Please DO NOT INCLUDE IDENTIFIABLE PATIENT information in your feedback. All feedback is helpful, you can send short or detailed feedback.

Prescribing where NHS Ipswich And East Suffolk CCG is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Pergolide mesilate 1 Dopaminergic drugs used in parkinsonism 14870 0.00 0.00 0.00 10.20
Epoetin zeta 1 Hypoplastic/haemolytic and renal anaemias 3 0.33 0.00 0.04 8.98
Hydrocort sodiumphos 393 Antibacterials 2971 0.13 0.01 0.02 7.52
Tiopronin 5 Rheumatic disease suppressant drugs 11032 0.00 0.00 0.00 6.06
Etodolac 2051 Non-steroidal anti-inflammatory drugs 29801 0.07 0.01 0.01 5.51

Prescribing where NHS Ipswich And East Suffolk CCG is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Tiotropium bromide 2660 Antimuscarinic bronchodilators 10204 0.26 0.69 0.14 -3.09
Tramadol hydrochloride 12613 Opioid analgesics 78718 0.16 0.26 0.04 -2.42
Tramadol 50mg capsules : 9168
Tramadol 100mg modified-release tablets : 158
Tramadol 150mg modified-release tablets : 14
Tramadol 200mg modified-release tablets : 28
Tramadol 50mg soluble tablets sugar free : 8
Tramadol 50mg modified-release capsules : 92
Tramadol 100mg modified-release capsules : 245
Tramadol 150mg modified-release capsules : 56
Tramadol 200mg modified-release capsules : 58
Tramadol 300mg modified-release tablets : 18
Tramadol 400mg modified-release tablets : 13
Tramadol 50mg orodispersible tablets sugar free : 21
Tramadol 37.5mg / Paracetamol 325mg tablets : 67
Tramadol 50mg modified-release tablets : 944
Zydol 50mg capsules : 1
Zydol SR 100mg tablets : 21
Zydol SR 150mg tablets : 6
Zydol SR 200mg tablets : 17
Zydol SR 50mg tablets : 15
Zamadol SR 100mg capsules : 15
Zamadol SR 200mg capsules : 5
Tramacet 37.5mg/325mg tablets : 11
Mabron 100mg modified-release tablets (Teva) : 9
Tradorec XL 200mg tablets : 1
Tramulief SR 100mg tablets : 16
Tramulief SR 150mg tablets : 6
Tramulief SR 200mg tablets : 11
Marol 200mg modified-release tablets (Teva) : 362
Marol 150mg modified-release tablets (Teva) : 267
Marol 100mg modified-release tablets (Teva) : 938
Maxitram SR 50mg capsules : 6
Maxitram SR 100mg capsules : 6
Maxitram SR 150mg capsules : 7
Invodol SR 200mg tablets : 3
Iodine compounds 10 Chlorine and iodine 15 0.67 0.96 0.12 -2.36
Doxycycline hyclate 4812 Tetracyclines 9767 0.49 0.64 0.06 -2.35
Sodium bicarbonate 1054 Oral bicarbonate 1056 1.00 1.00 0.00 -2.27