Static outliers for Winchester Rural South 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 Winchester Rural South PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sodium phenylbutyrate 6 Drugs used in metabolic disorders 12 0.50 0.00 0.04 12.68
Other vitamin A preparations 0906011 1 Vitamin A 1 1.00 0.02 0.11 8.92
Olmesartan medoxomil/hydrochlorothiazide 121 Angiotensin-II receptor antagonists 12180 0.01 0.00 0.00 7.39
Olmesartan medoxomil 2302 Angiotensin-II receptor antagonists 12180 0.19 0.02 0.02 7.24
Olmesartan medoxomil/amlodipine 156 Angiotensin-II receptor antagonists 12180 0.01 0.00 0.00 6.56

Prescribing where Winchester Rural South PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Vitamin A 0 Vitamin A 1 0.00 0.83 0.30 -2.74
Levothyroxine sodium 14689 Thyroid hormones 14787 0.99 1.00 0.00 -2.73
Finasteride 1124 Male sex hormones and antagonists 1783 0.63 0.83 0.07 -2.68
Moxonidine 12 Centrally-acting antihypertensive drugs 81 0.15 0.67 0.20 -2.66
Glucose blood testing reagents 1880 Diabetic diagnostic and monitoring agents 2112 0.89 0.94 0.02 -2.38
OneTouch Verio testing strips : 27
OneTouch Select Plus testing strips : 18
FreeStyle Optium testing strips : 68
GlucoMen areo Sensor testing strips : 48
Active testing strips : 13
FreeStyle testing strips : 1
FreeStyle Lite testing strips : 40
Aviva testing strips : 189
WaveSense JAZZ testing strips : 505
WaveSense JAZZ Duo testing strips : 18
Contour testing strips : 13
Mobile cassette : 183
GlucoRx Nexus testing strips : 444
GlucoRx HCT Glucose testing strips : 20
GlucoLab testing strips : 2
Contour Next testing strips : 88
TRUEyou testing strips : 40
Dario testing strips : 2
Contour TS testing strips : 19
GluNEO testing strips : 1
Performa testing strips : 60
palmdoc testing strips : 2
True Metrix testing strips : 2
4SURE testing strips : 26
Contour Plus testing strips : 35
Guide testing strips : 15
Instant testing strips : 1