Static outliers for Harness 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 Harness South PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Cyproheptadine hydrochloride 21 Antihistamines 5492 0.00 0.00 0.00 7.81
Propamidine isetionate 5 Antibacterials 300 0.02 0.00 0.00 5.56
Brinzolamide/brimonidine 314 Treatment of glaucoma 3722 0.08 0.02 0.01 5.09
Pridinol mesilate 7 Skeletal muscle relaxants 433 0.02 0.00 0.00 4.88
Chlorhexidine gluconate 3 Preparations for minor cuts and abrasions 6 0.50 0.02 0.10 4.57

Prescribing where Harness South PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Trimethoprim 291 Sulfonamides and trimethoprim 440 0.66 0.87 0.07 -3.10
Colecalciferol 12177 Vitamin D 13176 0.92 0.97 0.01 -2.90
Colecalciferol 3,000unit tablets : 5
Colecalciferol 800unit capsules : 140
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit tablets : 246
Colecalciferol 1,000unit capsules : 104
Colecalciferol 400unit capsules : 30
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 26
Colecalciferol 2,000units/ml oral drops sugar free : 24
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 16
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 464
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 11
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 744
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 1
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 82
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 136
Colecalciferol 10,000unit tablets : 1
Colecalciferol 20,000unit tablets : 75
Colecalciferol 800unit tablets : 42
Colecalciferol 40,000unit capsules : 3
Colecalciferol 200units/drop oral drops sugar free : 1
Colecalciferol 2,000unit tablets : 3
Colecalciferol 2,000unit orodispersible tablets sugar free : 1
Colecalciferol 25,000units/1ml soln ud amp sugar free : 33
Colecalciferol 25,000unit tablets : 2
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 2,400units/ml oral drops sugar free : 7
Colecalciferol 20,000unit capsules : 58
Colecalciferol 15,000units/5ml oral solution : 2
Colecalciferol 2,740units/ml oral drops sugar free : 4
Colecalciferol 10,000unit capsules : 1
Colecalciferol 4,000unit tablets : 2
Colecalciferol 25,000unit capsules : 3
Colecalciferol 400unit tablets : 10
Colecalciferol 400units/ml oral drops sugar free : 7
Colecalciferol 200units/drop oral drops : 4
Solgar Vitamin D3 1,000unit tablets : 2
Solgar Vitamin D3 1,000unit capsules : 2
Pro D3 400unit capsules : 7
Pro D3 1,000unit capsules : 8
Pro D3 2,500unit capsules : 7
Pro D3 20,000unit capsules : 3
Pro D3 2,000units/ml liquid drops : 5
Pro D3 2,000units/ml liquid : 6
Accrete D3 tablets : 1328
Accrete D3 One a Day 1000mg/880unit chewable tablets : 27
Valupak Vitamin D3 1,000unit tablets : 466
Valupak Vitamin D3 1,000unit capsules : 4
Adcal-D3 chewable tablets tutti frutti : 852
Adcal-D3 Lemon chewable tablets : 96
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 58
Adcal-D3 750mg/200unit caplets : 519
Cacit D3 effervescent granules sachets : 5
Calceos 500mg/400unit chewable tablets : 946
Calcichew D3 chewable tablets : 90
Calcichew D3 Forte chewable tablets : 282
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 8
Calfovit D3 oral powder sachets : 36
SunVit-D3 20,000unit tablets : 8
SunVit-D3 2,000unit tablets : 9
SunVit-D3 3,000unit tablets : 2
SunVit-D3 2,000units/ml oral solution : 3
SunVit-D3 2,000units/ml oral drops : 2
SunVit-D3 400unit tablets : 3
SunVit-D3 15,000units/5ml oral solution : 3
SunVit-D3 800unit capsules : 2
SunVit-D3 1,000unit capsules : 1
SunVit-D3 20,000unit capsules : 8
Fultium-D3 800unit capsules : 2441
Fultium-D3 3,200unit capsules : 2
Fultium-D3 20,000unit capsules : 558
Fultium-D3 2,740units/ml oral drops : 5
Pro D3 forte 3,000units/ml liquid : 3
Hux D3 20,000unit capsules : 134
Aciferol D3 2,000units/ml liquid : 5
Desunin 800unit tablets : 140
Plenachol D3 20,000unit capsules : 41
Plenachol D3 40,000unit capsules : 5
Evacal D3 1500mg/400unit chewable tablets : 19
InVita D3 25,000units/1ml oral solution : 41
InVita D3 2,400units/ml oral drops : 19
InVita D3 800unit capsules : 115
InVita D3 400unit capsules : 4
InVita D3 5,600unit capsules : 6
Stexerol-D3 1,000unit tablets : 1106
Stexerol-D3 25,000unit tablets : 226
Thorens 10,000units/ml oral drops : 25
Thorens 25,000units/2.5ml oral solution : 12
Calci-D 1000mg/1,000unit chewable tablets : 182
Water for injection 18 Electrolytes and water 46 0.39 0.81 0.17 -2.51
Calcium carbonate 103 Calcium supplements 123 0.84 0.96 0.05 -2.48
Methotrexate 353 Rheumatic disease suppressant drugs 1098 0.32 0.59 0.11 -2.46