Static outliers for Balham, Tooting & Furzedown 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 Balham, Tooting & Furzedown PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Squill 7 Expectorant and demulcent cough preparations 27 0.26 0.0 0.01 24.54
Oxitriptan 3 Other antidepressant drugs 4859 0.00 0.0 0.00 22.96
Dextromethorphan hydrobrom compound prepartions 1 Expectorant and demulcent cough preparations 27 0.04 0.0 0.00 13.52
Arnica montana 10 Rubefacients, topical NSAIDS, capsaicin and poultice 2535 0.00 0.0 0.00 13.17
Tazarotene 2 Preparations for psoriasis 371 0.01 0.0 0.00 7.72

Prescribing where Balham, Tooting & Furzedown PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 13174 Vitamin D 14219 0.93 0.97 0.01 -2.74
Colecalciferol 3,000unit tablets : 2
Colecalciferol 800unit capsules : 602
Colecalciferol 600unit capsules : 2
Colecalciferol 1,000unit tablets : 370
Colecalciferol 1,000unit capsules : 36
Colecalciferol 400unit capsules : 53
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 79
Colecalciferol 2,000units/ml oral drops sugar free : 15
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 12
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 355
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 46
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 2666
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 20
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 238
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 392
Colecalciferol 400units/dose oral spray sugar free : 4
Colecalciferol 20,000unit tablets : 9
Colecalciferol 800unit tablets : 379
Colecalciferol 40,000unit capsules : 20
Colecalciferol 50,000unit tablets : 1
Colecalciferol 2,000unit tablets : 8
Colecalciferol 25,000units/1ml soln ud amp sugar free : 2
Colecalciferol 25,000unit tablets : 1
Colecalciferol 10,000units/ml oral drops sugar free : 2
Colecalciferol 2,400units/ml oral drops sugar free : 4
Colecalciferol 20,000unit capsules : 21
Colecalciferol 4,000unit tablets : 27
Colecalciferol 25,000unit capsules : 4
Colecalciferol 400unit tablets : 72
Colecalciferol 50,000unit capsules : 1
Colecalciferol 400units/ml oral drops sugar free : 2
Colecalciferol 200units/drop oral drops : 14
BabyD 1,000units/ml oral solution : 1
Pro D3 400unit capsules : 29
Pro D3 1,000unit capsules : 18
Pro D3 2,500unit capsules : 4
Pro D3 10,000unit capsules : 2
Pro D3 2,000units/ml liquid drops : 1
Pro D3 800unit capsules : 6
Accrete D3 tablets : 176
Accrete D3 One a Day 1000mg/880unit chewable tablets : 71
Valupak Vitamin D3 1,000unit tablets : 73
Valupak Vitamin D3 1,000unit capsules : 1
Adcal-D3 chewable tablets tutti frutti : 1943
Adcal-D3 Lemon chewable tablets : 315
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 77
Adcal-D3 750mg/200unit caplets : 1665
Calceos 500mg/400unit chewable tablets : 36
Calcichew D3 chewable tablets : 68
Calcichew D3 Forte chewable tablets : 330
Calfovit D3 oral powder sachets : 1
Natecal D3 600mg/400unit chewable tablets : 36
SunVit-D3 10,000unit tablets : 1
SunVit-D3 2,000units/ml oral drops : 1
SunVit-D3 10,000unit capsules : 3
SunVit-D3 25,000unit tablets : 3
SunVit-D3 20,000unit capsules : 4
Fultium-D3 800unit capsules : 38
Fultium-D3 3,200unit capsules : 6
Fultium-D3 20,000unit capsules : 6
Fultium-D3 2,740units/ml oral drops : 1
Bio-Vitamin D3 20,000unit capsules : 1
Hux D3 20,000unit capsules : 248
Aciferol D3 1,000unit tablets : 4
Desunin 800unit tablets : 1152
Desunin 4,000unit tablets : 1
Plenachol D3 20,000unit capsules : 82
Plenachol D3 40,000unit capsules : 51
Evacal D3 1500mg/400unit chewable tablets : 163
InVita D3 25,000units/1ml oral solution : 13
InVita D3 2,400units/ml oral drops : 2
InVita D3 800unit capsules : 2
Stexerol-D3 1,000unit tablets : 843
Stexerol-D3 25,000unit tablets : 46
Thorens 10,000units/ml oral drops : 3
Thorens 25,000units/2.5ml oral solution : 10
Calci-D 1000mg/1,000unit chewable tablets : 175
Strivit-D3 800unit capsules : 3
Prednisolone 1298 Use of corticosteroids 1612 0.81 0.88 0.03 -2.39
Gabapentin 913 Control of epilepsy 9377 0.10 0.23 0.06 -2.26
Spironolactone 1066 Potassium-sparing diuretics and aldosterone antagonists 2082 0.51 0.72 0.10 -2.19
Terbinafine hydrochloride 106 Other antifungals 111 0.95 0.99 0.02 -2.17