Static outliers for Healthy Crawley 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 Healthy Crawley PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Other expectorantand demulcent cough preparations 3 Expectorant and demulcent cough preparations 13 0.23 0.00 0.02 14.61
Sodium fusidate 13 Some other antibacterials 34 0.38 0.01 0.04 9.99
Gentamicin sulfate 1 Antibacterial preparations also used systemically 281 0.00 0.00 0.00 7.57
Glutaraldehyde 7 Preparations for warts and calluses 40 0.18 0.01 0.03 5.69
Lacidipine 1198 Calcium-channel blockers 11714 0.10 0.01 0.02 4.85

Prescribing where Healthy Crawley PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Simple 6 Expectorant and demulcent cough preparations 13 0.46 0.96 0.13 -3.93
Chloramphenicol 226 Antibacterials 370 0.61 0.77 0.07 -2.26
Vitamin E 0 Vitamin E 1 0.00 0.73 0.33 -2.24
Beclometasone dipropionate 2203 Corticosteroids (respiratory) 6184 0.36 0.56 0.10 -2.16
Beclometasone 50micrograms/dose inhaler CFC free : 4
Beclometasone 100micrograms/dose inhaler CFC free : 23
Beclometasone 50micrograms/dose breath actuated inh CFC free : 2
Beclometasone 100mcg/dose breath actuated inhaler CFC free : 7
Beclometasone 200micrograms/dose inhaler CFC free : 1
Beclometasone 100microg/Formoterol 6microg/dose inh CFCfree : 3
Beclometasone 100microg/Formoterol 6microg/dose dry pdr inh : 3
Beclometasone 200microg/Formoterol 6microg/dose inh CFC free : 2
Beclometasone 200microg/Formoterol 6microg/dose dry pdr inh : 2
Qvar 50 inhaler : 51
Qvar 100 inhaler : 93
Qvar 50 Autohaler : 34
Qvar 100 Autohaler : 14
Qvar 50micrograms/dose Easi-Breathe inhaler : 21
Qvar 100micrograms/dose Easi-Breathe inhaler : 45
Clenil Modulite 50micrograms/dose inhaler : 179
Clenil Modulite 100micrograms/dose inhaler : 934
Clenil Modulite 200micrograms/dose inhaler : 156
Clenil Modulite 250micrograms/dose inhaler : 18
Fostair 100micrograms/dose / 6micrograms/dose inhaler : 405
Fostair 200micrograms/dose / 6micrograms/dose inhaler : 119
Fostair NEXThaler 100microg/dose / 6microg/dose dry pdr inh : 65
Fostair NEXThaler 200microg/dose / 6microg/dose dry pdr inh : 13
Soprobec 100micrograms/dose inhaler : 9
Flecainide acetate 27 Drugs for arrhythmias 194 0.14 0.46 0.15 -2.12