Static outliers for Mayday 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 Mayday South PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Paracetamol and ibuprofen 7 Non-opioid analgesics and compound preparations 5485 0.00 0.00 0.00 34.38
Cholera 7 Vaccines and antisera 117 0.06 0.00 0.00 14.56
Rutosides 1 Peripheral vasodilators and related drugs 1 1.00 0.06 0.13 7.17
Diethylamine salicylate 323 Rubefacients, topical NSAIDS, capsaicin and poultice 1049 0.31 0.03 0.04 6.85
Cetylpyridinium chloride 4 Mouth-washes, gargles and dentifrices 62 0.06 0.00 0.01 6.68

Prescribing where Mayday South PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Potassium permanganate 0 Oxidisers and dyes 1 0.00 0.93 0.20 -4.70
Colecalciferol 3790 Vitamin D 4122 0.92 0.97 0.01 -3.24
Colecalciferol 3,000unit tablets : 4
Colecalciferol 800unit capsules : 337
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit tablets : 126
Colecalciferol 1,000unit capsules : 61
Colecalciferol 400unit capsules : 34
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 3
Colecalciferol 2,000units/ml oral drops sugar free : 2
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 44
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 215
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 1
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 1040
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 4
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 115
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 455
Colecalciferol 5,000unit tablets : 2
Colecalciferol 10,000unit tablets : 2
Colecalciferol 800unit tablets : 175
Colecalciferol 40,000unit capsules : 45
Colecalciferol 200units/drop oral drops sugar free : 1
Colecalciferol 2,000unit tablets : 3
Colecalciferol 3,200unit capsules : 6
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 1
Colecalciferol 25,000unit tablets : 3
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 20,000unit capsules : 129
Colecalciferol 2,200unit capsules : 5
Colecalciferol 5,000unit capsules : 2
Colecalciferol 4,000unit tablets : 2
Colecalciferol 25,000unit capsules : 1
Colecalciferol 400units/ml oral drops sugar free : 1
Colecalciferol 200units/drop oral drops : 3
Pro D3 2,000units/ml liquid : 4
Accrete D3 tablets : 27
Valupak Vitamin D3 1,000unit tablets : 49
Adcal-D3 chewable tablets tutti frutti : 271
Adcal-D3 Lemon chewable tablets : 6
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 21
Adcal-D3 750mg/200unit caplets : 172
Calceos 500mg/400unit chewable tablets : 10
Calcichew D3 chewable tablets : 13
Calcichew D3 Forte chewable tablets : 10
SunVit-D3 5,000unit tablets : 4
SunVit-D3 800unit tablets : 5
SunVit-D3 10,000unit capsules : 1
Fultium-D3 800unit capsules : 42
Fultium-D3 3,200unit capsules : 3
Fultium-D3 2,740units/ml oral drops : 3
Bio-Vitamin D3 1,000unit capsules : 6
Hux D3 20,000unit capsules : 86
Desunin 800unit tablets : 12
Plenachol D3 20,000unit capsules : 19
Plenachol D3 40,000unit capsules : 8
Evacal D3 1500mg/400unit chewable tablets : 45
TheiCal-D3 1000mg/880unit chewable tablets : 3
Stexerol-D3 1,000unit tablets : 40
Stexerol-D3 25,000unit tablets : 13
Thorens 10,000units/ml oral drops : 4
Thorens 25,000units/2.5ml oral solution : 1
Calci-D 1000mg/1,000unit chewable tablets : 86
ColeDose D3 20,000unit capsules : 2
Methotrexate 188 Rheumatic disease suppressant drugs 624 0.30 0.59 0.11 -2.65
Mirabegron 78 Drugs for urinary frequency enuresis and incontinence 837 0.09 0.23 0.06 -2.39
Naftidrofuryl oxalate 0 Peripheral vasodilators and related drugs 1 0.00 0.67 0.28 -2.38