Static outliers for Aegis Healthcare PCN

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 Aegis Healthcare PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Other topical anaesthetic and antipruritic preparations 1 Topical local anaesthetics and antipruritics 77 0.01 0.00 0.00 15.62
Teicoplanin 8 Some other antibacterials 43 0.19 0.00 0.02 11.19
Fulvestrant 6 Breast cancer 518 0.01 0.00 0.00 7.02
Probenecid 5 Gout and cytotoxic induced hyperiuicaemia 1813 0.00 0.00 0.00 5.72
Vardenafil 96 Drugs for erectile dysfunction 1214 0.08 0.02 0.01 5.67

Prescribing where Aegis Healthcare PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Terbinafine hydrochloride 135 Other antifungals 148 0.91 0.99 0.02 -4.64
Medroxyprogesterone acetate 183 Parenteral progestogen-only contraceptives 408 0.45 0.86 0.11 -3.86
Methylprednisolone acetate 4 Local corticosteroid injections 95 0.04 0.73 0.29 -2.36
Colecalciferol 7588 Vitamin D 8142 0.93 0.97 0.01 -2.35
Colecalciferol 3,000unit tablets : 3
Colecalciferol 800unit capsules : 70
Colecalciferol 1,000unit tablets : 195
Colecalciferol 1,000unit capsules : 26
Colecalciferol 400unit capsules : 13
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 3
Colecalciferol 2,000units/ml oral drops sugar free : 1
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 6
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 28
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 6
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 205
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 81
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 292
Colecalciferol 300,000units/1ml inj ampoules : 2
Colecalciferol 5,000unit tablets : 1
Colecalciferol 10,000unit tablets : 6
Colecalciferol 20,000unit tablets : 12
Colecalciferol 800unit tablets : 17
Colecalciferol 10,000units/5ml oral solution : 2
Colecalciferol 50,000unit tablets : 22
Colecalciferol 2,000unit tablets : 12
Colecalciferol 3,200unit capsules : 5
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 10
Colecalciferol 25,000unit tablets : 6
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 2
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 10,000units/ml oral solution sugar free : 1
Colecalciferol 20,000unit capsules : 14
Colecalciferol 15,000units/5ml oral solution : 5
Colecalciferol 10,000unit capsules : 1
Colecalciferol 3,000unit capsules : 1
Colecalciferol 5,000unit capsules : 1
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 22
Colecalciferol 25,000unit capsules : 5
Colecalciferol 400unit tablets : 21
Colecalciferol 10,000units/5ml oral solution sugar free : 5
Colecalciferol 50,000unit capsules : 3
Pro D3 1,000unit capsules : 16
Pro D3 10,000unit capsules : 1
Pro D3 2,000units/ml liquid : 26
Accrete D3 tablets : 53
Accrete D3 One a Day 1000mg/880unit chewable tablets : 5
Valupak Vitamin D3 1,000unit tablets : 29
Adcal-D3 chewable tablets tutti frutti : 1117
Adcal-D3 Lemon chewable tablets : 117
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 203
Adcal-D3 750mg/200unit caplets : 1435
Cacit D3 effervescent granules sachets : 3
Calceos 500mg/400unit chewable tablets : 460
Calcichew D3 chewable tablets : 26
Calcichew D3 Forte chewable tablets : 35
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 10
SunVit-D3 1,000unit tablets : 22
SunVit-D3 10,000unit tablets : 13
SunVit-D3 20,000unit tablets : 7
SunVit-D3 2,000unit tablets : 2
SunVit-D3 2,000units/ml oral solution : 6
SunVit-D3 2,000units/ml oral drops : 1
Fultium-D3 800unit capsules : 165
Fultium-D3 3,200unit capsules : 31
Fultium-D3 20,000unit capsules : 32
Pro D3 forte 3,000units/ml liquid : 11
Hux D3 20,000unit capsules : 96
Aciferol D3 1,000unit tablets : 25
Aciferol D3 2,200unit tablets : 5
Aciferol D3 3,000units/ml liquid : 3
Aciferol D3 2,000units/ml liquid : 2
Desunin 800unit tablets : 6
Evacal D3 1500mg/400unit chewable tablets : 1391
InVita D3 25,000units/1ml oral solution : 4
InVita D3 50,000units/1ml oral solution : 1
InVita D3 800unit capsules : 61
InVita D3 50,000unit capsules : 3
InVita D3 25,000unit capsules : 3
TheiCal-D3 1000mg/880unit chewable tablets : 58
Stexerol-D3 1,000unit tablets : 82
Stexerol-D3 25,000unit tablets : 4
Calci-D 1000mg/1,000unit chewable tablets : 912
Cabergoline 11 Bromocriptine and other dopaminergic drugs 24 0.46 0.85 0.17 -2.35