Static outliers for Peterborough Partnerships 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 Peterborough Partnerships PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Felbinac 5 Rubefacients, topical NSAIDS, capsaicin and poultice 766 0.01 0.0 0.00 13.54
Atropine sulfate 1 Antispasmodic and other drugs altering gut motility 819 0.00 0.0 0.00 12.48
Hydrocortisone butyrate 104 Topical corticosteroids 2557 0.04 0.0 0.00 10.24
Ospemifene 3 Preparations for vaginal/vulval changes 242 0.01 0.0 0.00 7.25
Co-simalcite (Simeticone/hydrotalcite) 1 Antacids and simeticone 17 0.06 0.0 0.01 6.19

Prescribing where Peterborough Partnerships PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 3849 Vitamin D 4211 0.91 0.97 0.01 -3.62
Colecalciferol 800unit capsules : 76
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit tablets : 22
Colecalciferol 1,000unit capsules : 3
Colecalciferol 400unit capsules : 4
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 6
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 12
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 52
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 58
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 11
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 31
Colecalciferol 5,000unit tablets : 2
Colecalciferol 800unit tablets : 11
Colecalciferol 3,200unit capsules : 1
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 4
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 20,000unit capsules : 8
Colecalciferol 50,000units/1ml soln ud amp sugar free : 2
Colecalciferol 2,200unit capsules : 2
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 2
Colecalciferol 4,000unit tablets : 1
Colecalciferol 25,000unit capsules : 8
Colecalciferol 400unit tablets : 17
BabyD 1,000units/ml oral solution : 3
Accrete D3 tablets : 269
Accrete D3 One a Day 1000mg/880unit chewable tablets : 685
Valupak Vitamin D3 1,000unit tablets : 5
Adcal-D3 chewable tablets tutti frutti : 478
Adcal-D3 Lemon chewable tablets : 129
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 30
Adcal-D3 750mg/200unit caplets : 266
Cacit D3 effervescent granules sachets : 5
Calceos 500mg/400unit chewable tablets : 168
Calcichew D3 chewable tablets : 17
Calcichew D3 Forte chewable tablets : 101
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 17
SunVit-D3 1,000unit tablets : 2
SunVit-D3 20,000unit tablets : 3
SunVit-D3 2,000unit tablets : 1
SunVit-D3 800unit tablets : 6
Fultium-D3 800unit capsules : 55
Fultium-D3 3,200unit capsules : 34
Fultium-D3 20,000unit capsules : 8
Hux D3 20,000unit capsules : 62
Desunin 800unit tablets : 114
Desunin 4,000unit tablets : 1
Evacal D3 1500mg/400unit chewable tablets : 670
HealthAid Vitamin D3 200units/drop oral drops : 1
InVita D3 25,000units/1ml oral solution : 107
InVita D3 2,400units/ml oral drops : 1
InVita D3 50,000units/1ml oral solution : 19
InVita D3 800unit capsules : 25
InVita D3 50,000unit capsules : 161
InVita D3 25,000unit capsules : 4
Stexerol-D3 1,000unit tablets : 1
Thorens 10,000units/ml oral drops : 8
Calci-D 1000mg/1,000unit chewable tablets : 56
Strivit-D3 20,000unit capsules : 2
Urea hydrogen peroxide 1 Removal of ear wax and other substances 4 0.25 0.83 0.26 -2.25
Azathioprine 209 Antiproliferative immunosuppressants 363 0.58 0.80 0.10 -2.21
Moxonidine 27 Centrally-acting antihypertensive drugs 102 0.26 0.67 0.20 -2.07
Hydralazine hydrochloride 29 Vasodilator antihypertensive drugs 56 0.52 0.86 0.17 -1.96