Static outliers for One Life Hartlepool 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 One Life Hartlepool PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Buserelin 5 Prostate cancer and gonadorelin analogues 218 0.02 0.00 0.00 29.58
Lidocaine hydrochloride 16 Drugs for oral ulceration and inflammation 114 0.14 0.01 0.02 8.16
Buspirone hydrochloride 358 Anxiolytics 1283 0.28 0.03 0.04 5.97
Gluten free pasta 1 Foods for special diets 589 0.00 0.00 0.00 5.49
Diltiazem hydrochloride 1670 Calcium-channel blockers 11744 0.14 0.05 0.02 4.72
Diltiazem 60mg modified-release tablets : 36
Diltiazem 90mg modified-release tablets : 5
Diltiazem 300mg modified-release capsules : 6
Diltiazem 120mg modified-release tablets : 2
Diltiazem 240mg modified-release capsules : 4
Diltiazem 360mg modified-release capsules : 31
Tildiem 60mg modified-release tablets : 35
Tildiem Retard 90mg tablets : 27
Tildiem Retard 120mg tablets : 12
Tildiem LA 300 capsules : 5
Adizem-SR 90mg capsules : 87
Adizem-SR 120mg capsules : 74
Adizem-SR 180mg capsules : 54
Adizem-XL 300mg capsules : 143
Adizem-XL 120mg capsules : 357
Adizem-XL 180mg capsules : 322
Adizem-XL 240mg capsules : 403
Adizem-XL 200mg capsules : 18
Angitil SR 90 capsules : 22
Angitil SR 120 capsules : 6
Zemtard 180 XL capsules : 1
Viazem XL 120mg capsules : 3
Viazem XL 240mg capsules : 7
Viazem XL 360mg capsules : 10

Prescribing where One Life Hartlepool PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Diazepam 559 Anxiolytics 1283 0.44 0.76 0.08 -4.16
Folic acid 1177 Drugs used in megaloblastic anaemias 4098 0.29 0.68 0.13 -2.99
Amitriptyline hydrochloride 4673 Tricyclic and related antidepressant drugs 6744 0.69 0.84 0.05 -2.74
Glucose blood testing reagents 1764 Diabetic diagnostic and monitoring agents 1994 0.88 0.94 0.02 -2.63
Citalopram hydrobromide 2961 Selective serotonin re-uptake inhibitors 15987 0.19 0.32 0.05 -2.53