Static outliers for One Thornton Heath 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 Thornton Heath PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ketoprofen 29 Non-steroidal anti-inflammatory drugs 1978 0.01 0.00 0.00 6.98
Levonorgestrel 50 Oral progestogen-only contraceptives 769 0.07 0.01 0.01 6.61
Abacavir and lamivudine 1 HIV infection 6 0.17 0.00 0.03 6.24
Dolutegravir 2 HIV infection 6 0.33 0.01 0.06 5.81
Pentazocine hydrochloride 5 Opioid analgesics 3120 0.00 0.00 0.00 5.71

Prescribing where One Thornton Heath PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Desogestrel 613 Oral progestogen-only contraceptives 769 0.80 0.94 0.03 -5.40
Acamprosate calcium 0 Alcohol dependence 1 0.00 0.83 0.24 -3.51
Potassium permanganate 2 Oxidisers and dyes 7 0.29 0.93 0.20 -3.27
Urea hydrogen peroxide 0 Removal of ear wax and other substances 2 0.00 0.83 0.26 -3.22
Colecalciferol 5742 Vitamin D 6228 0.92 0.97 0.01 -3.06
Colecalciferol 3,000unit tablets : 4
Colecalciferol 800unit capsules : 434
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit tablets : 58
Colecalciferol 1,000unit capsules : 43
Colecalciferol 400unit capsules : 6
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 1
Colecalciferol 2,000units/ml oral drops sugar free : 14
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 36
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 181
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 22
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 1795
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 117
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 63
Colecalciferol 20,000unit tablets : 11
Colecalciferol 800unit tablets : 261
Colecalciferol 40,000unit capsules : 31
Colecalciferol 2,000unit tablets : 26
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 2
Colecalciferol 25,000unit tablets : 2
Colecalciferol 10,000units/ml oral drops sugar free : 3
Colecalciferol 10,000units/ml oral solution sugar free : 5
Colecalciferol 20,000unit capsules : 138
Colecalciferol 15,000units/5ml oral solution : 1
Colecalciferol 2,740units/ml oral drops sugar free : 1
Colecalciferol 10,000unit capsules : 1
Colecalciferol 2,200unit capsules : 3
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 5
Colecalciferol 4,000unit tablets : 2
Colecalciferol 400unit tablets : 20
Colecalciferol 50,000unit capsules : 2
Colecalciferol 400units/ml oral drops sugar free : 2
Colecalciferol 200units/drop oral drops : 7
Accrete D3 tablets : 31
Adcal-D3 chewable tablets tutti frutti : 469
Adcal-D3 Lemon chewable tablets : 191
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 64
Adcal-D3 750mg/200unit caplets : 612
Calceos 500mg/400unit chewable tablets : 11
Calcichew D3 chewable tablets : 86
Calcichew D3 Forte chewable tablets : 85
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 2
SunVit-D3 3,200unit capsules : 1
SunVit-D3 10,000unit capsules : 7
SunVit-D3 25,000unit tablets : 5
Fultium-D3 800unit capsules : 121
Fultium-D3 3,200unit capsules : 1
Hux D3 20,000unit capsules : 62
Desunin 800unit tablets : 75
Plenachol D3 20,000unit capsules : 4
Plenachol D3 40,000unit capsules : 19
OsteoCaps D3 1,000unit capsules : 6
Evacal D3 1500mg/400unit chewable tablets : 420
InVita D3 50,000unit capsules : 1
TheiCal-D3 1000mg/880unit chewable tablets : 15
Stexerol-D3 1,000unit tablets : 97
Stexerol-D3 25,000unit tablets : 48
Thorens 10,000units/ml oral drops : 4
Thorens 25,000units/2.5ml oral solution : 3
Calci-D 1000mg/1,000unit chewable tablets : 1
SunVit-D3 400unit with Calcium 500mg chewable tablets : 1
ColeDose D3 20,000unit capsules : 2