Static outliers for At Medics Streatham 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 At Medics Streatham PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Cefuroxime sodium 1 Antibacterials 127 0.01 0.00 0.00 21.41
Calcium polystyrene sulfonate 10 Oral potassium 21 0.48 0.01 0.04 12.28
Tolvaptan 1 Posterior pituitary hormones and antagonists 15 0.07 0.00 0.01 11.23
Emulsifying wax 182 Emollients 821 0.22 0.01 0.02 10.68
Torasemide 20 Loop diuretics 1203 0.02 0.00 0.00 6.51

Prescribing where At Medics Streatham PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Desmopressin acetate 14 Posterior pituitary hormones and antagonists 15 0.93 1.00 0.01 -11.23
Potassium chloride 11 Oral potassium 21 0.52 0.98 0.06 -7.29
Fluconazole 82 Triazole antifungals 158 0.52 0.85 0.07 -4.86
Colecalciferol 2409 Vitamin D 2670 0.90 0.97 0.01 -4.46
Colecalciferol 800unit capsules : 150
Colecalciferol 1,000unit tablets : 85
Colecalciferol 1,000unit capsules : 35
Colecalciferol 400unit capsules : 5
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 2
Colecalciferol 2,000units/ml oral drops sugar free : 2
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 67
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 8
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 545
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 19
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 35
Colecalciferol 20,000unit tablets : 1
Colecalciferol 800unit tablets : 65
Colecalciferol 40,000unit capsules : 5
Colecalciferol 200units/drop oral drops sugar free : 2
Colecalciferol 2,000unit tablets : 29
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 3
Colecalciferol 10,000units/ml oral drops sugar free : 3
Colecalciferol 20,000unit capsules : 67
Colecalciferol 5,000unit capsules : 3
Colecalciferol 400unit tablets : 9
Colecalciferol 200units/drop oral drops : 2
Solgar Vitamin D3 1,000unit capsules : 2
Pro D3 1,000unit capsules : 28
Pro D3 20,000unit capsules : 2
Pro D3 2,000units/ml liquid drops : 2
Accrete D3 tablets : 176
Accrete D3 One a Day 1000mg/880unit chewable tablets : 1
Valupak Vitamin D3 1,000unit tablets : 25
Adcal-D3 chewable tablets tutti frutti : 342
Adcal-D3 Lemon chewable tablets : 38
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 53
Adcal-D3 750mg/200unit caplets : 82
Calceos 500mg/400unit chewable tablets : 12
Calcichew D3 chewable tablets : 24
Calcichew D3 Forte chewable tablets : 14
SunVit-D3 1,000unit tablets : 6
SunVit-D3 20,000unit capsules : 1
Fultium-D3 800unit capsules : 74
Fultium-D3 3,200unit capsules : 1
Fultium-D3 20,000unit capsules : 8
Fultium-D3 2,740units/ml oral drops : 4
Pro D3 forte 3,000units/ml liquid : 3
Hux D3 20,000unit capsules : 24
Aciferol D3 1,000unit tablets : 32
Desunin 800unit tablets : 149
Desunin 4,000unit tablets : 1
Plenachol D3 20,000unit capsules : 38
Evacal D3 1500mg/400unit chewable tablets : 23
InVita D3 25,000units/1ml oral solution : 1
InVita D3 50,000units/1ml oral solution : 2
TheiCal-D3 1000mg/880unit chewable tablets : 20
Stexerol-D3 1,000unit tablets : 60
Thorens 10,000units/ml oral drops : 15
Thorens 25,000units/2.5ml oral solution : 3
Calci-D 1000mg/1,000unit chewable tablets : 1
Other emollient preparations 603 Emollients 821 0.73 0.89 0.04 -3.58