Static outliers for White Horse Botley 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 White Horse Botley PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Meningococcal B vaccine 7 Vaccines and antisera 38 0.18 0.0 0.01 35.89
Magnesium sulfate 6 Osmotic laxatives 2169 0.00 0.0 0.00 14.86
Eprosartan 242 Angiotensin-II receptor antagonists 6034 0.04 0.0 0.00 10.97
Clozapine 33 Antipsychotic drugs 1701 0.02 0.0 0.00 9.84
Meningococcal A + C + W135 + Y vaccine 3 Vaccines and antisera 38 0.08 0.0 0.01 9.45

Prescribing where White Horse Botley PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Other food for special diet preparations 42 Foods for special diets 216 0.19 0.64 0.17 -2.58
Solifenacin 209 Drugs for urinary frequency enuresis and incontinence 1780 0.12 0.33 0.08 -2.56
Amlodipine 5845 Calcium-channel blockers 10296 0.57 0.75 0.08 -2.18
Doxycycline hyclate 330 Tetracyclines 759 0.43 0.63 0.09 -2.17
Diazepam 551 Anxiolytics 927 0.59 0.76 0.08 -2.13