Static outliers for NHS Hampshire, Southampton And Isle Of Wight 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 Hampshire, Southampton And Isle Of Wight CCG is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Tildrakizumab 1 Drugs affecting the immune response 2700 0.0 0.0 0.0 10.20
Etamsylate 1 Antifibrinolytic drugs and haemostatics 5306 0.0 0.0 0.0 10.20
Nilotinib 2 Other antineoplastic drugs 2770 0.0 0.0 0.0 9.85
Dasatinib 1 Other antineoplastic drugs 2770 0.0 0.0 0.0 9.85
Other vaginal/vulva changes preparations 5 Preparations for vaginal/vulval changes 34354 0.0 0.0 0.0 9.56

Prescribing where NHS Hampshire, Southampton And Isle Of Wight CCG is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Tranexamic acid 5305 Antifibrinolytic drugs and haemostatics 5306 1.00 1.00 0.00 -10.20
Alfentanil hydrochloride 7 Opioid analgesics 30 0.23 0.92 0.21 -3.24
Levothyroxine sodium 322169 Thyroid hormones 323549 1.00 1.00 0.00 -2.42
Levothyroxine sodium 50microgram capsules : 8
Levothyroxine sodium 25microgram capsules : 3
Levothyroxine sodium 25microgram tablets : 90247
Levothyroxine sodium 50microgram tablets : 95983
Levothyroxine sodium 75microgram tablets : 10392
Levothyroxine sodium 100microgram tablets : 124370
Levothyroxine sodium 100microgram capsules : 13
Levothyroxine sodium 50micrograms/5ml oral liquid : 2
Levothyroxine sodium 25micrograms/5ml oral liquid : 1
Levothyroxine sodium 25micrograms/5ml soln sugar free : 71
Levothyroxine sodium 50micrograms/5ml soln sugar free : 226
Levothyroxine sodium 100micrograms/5ml soln sugar free : 163
Levothyroxine sodium 12.5microgram tablets : 487
Levothyroxine sodium 125micrograms/5ml soln sugar free : 16
Eltroxin 50microgram tablets : 55
Eltroxin 100microgram tablets : 68
Eltroxin 25microgram tablets : 64
Finasteride 33984 Male sex hormones and antagonists 48007 0.71 0.83 0.05 -2.40
Aciclovir 13373 Herpes simplex and varicella-zoster 14778 0.90 0.95 0.02 -2.15