Static outliers for Hulme & City Centre 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 Hulme & City Centre South PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ceftriaxone sodium 18 Cephalosporins 119 0.15 0.00 0.00 31.78
Arachis oil 6 Shampoos and some other scalp preparations 455 0.01 0.00 0.00 11.28
Nicotinates 8 Rubefacients, topical NSAIDS, capsaicin and poultice 1453 0.01 0.00 0.00 9.84
Estradiol valerate 150 Oestrogens and Hormone Replacement Therapy 674 0.22 0.03 0.02 9.49
Tropicamide 5 Mydriatics and cycloplegics 9 0.56 0.02 0.06 8.30

Prescribing where Hulme & City Centre South PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Hydralazine hydrochloride 0 Vasodilator antihypertensive drugs 5 0.00 0.86 0.17 -4.94
Colecalciferol 1781 Vitamin D 1966 0.91 0.97 0.01 -4.20
Colecalciferol 3,000unit tablets : 8
Colecalciferol 800unit capsules : 87
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit tablets : 4
Colecalciferol 1,000unit capsules : 14
Colecalciferol 400unit capsules : 13
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 84
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 2
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 183
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 13
Colecalciferol 20,000unit tablets : 6
Colecalciferol 800unit tablets : 46
Colecalciferol 40,000unit capsules : 5
Colecalciferol 50,000unit tablets : 1
Colecalciferol 2,000unit tablets : 5
Colecalciferol 2,000unit orodispersible tablets sugar free : 1
Colecalciferol 25,000unit tablets : 1
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 20,000unit capsules : 26
Colecalciferol 5,000unit capsules : 7
Colecalciferol 4,000unit tablets : 9
Colecalciferol 400unit tablets : 17
Colecalciferol 200units/drop oral drops : 2
Pro D3 2,000units/ml liquid drops : 1
Accrete D3 tablets : 6
Adcal-D3 chewable tablets tutti frutti : 329
Adcal-D3 Lemon chewable tablets : 70
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 24
Adcal-D3 750mg/200unit caplets : 71
Cacit D3 effervescent granules sachets : 9
Calceos 500mg/400unit chewable tablets : 28
Calcichew D3 chewable tablets : 6
Calcichew D3 Forte chewable tablets : 334
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 5
Calfovit D3 oral powder sachets : 10
Natecal D3 600mg/400unit chewable tablets : 5
SunVit-D3 20,000unit tablets : 4
Fultium-D3 800unit capsules : 23
Fultium-D3 20,000unit capsules : 1
Fultium-D3 2,740units/ml oral drops : 1
Hux D3 20,000unit capsules : 300
Desunin 800unit tablets : 5
Plenachol D3 20,000unit capsules : 1
Evacal D3 1500mg/400unit chewable tablets : 2
InVita D3 25,000units/1ml oral solution : 1
Thorens 10,000units/ml oral drops : 4
Calci-D 1000mg/1,000unit chewable tablets : 3
Strivit-D3 20,000unit capsules : 2
Isosorbide mononitrate 321 Nitrates 594 0.54 0.73 0.07 -2.86
Zinc oxide 30 Soothing haemorrhoidal preparations 80 0.38 0.77 0.14 -2.82
Finasteride 362 Male sex hormones and antagonists 578 0.63 0.83 0.07 -2.74