Static outliers for West Birmingham 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 West Birmingham PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Macitentan 1 Vasodilator antihypertensive drugs 37 0.03 0.00 0.00 32.06
Losartan potassium with diuretic 684 Angiotensin-II receptor antagonists 3826 0.18 0.01 0.01 18.43
Analgesics with anti-emetics 110 Treatment of acute migraine 331 0.33 0.03 0.03 10.26
Metformin hydrochloride/vildagliptin 222 Other antidiabetic drugs 4511 0.05 0.00 0.00 10.16
Alkyl sulfate 14 Shampoos and some other scalp preparations 432 0.03 0.00 0.00 8.95

Prescribing where West Birmingham PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 4154 Vitamin D 4575 0.91 0.97 0.01 -4.05
Colecalciferol 3,000unit tablets : 1
Colecalciferol 800unit capsules : 24
Colecalciferol 1,000unit tablets : 85
Colecalciferol 1,000unit capsules : 2
Colecalciferol 400unit capsules : 5
Colecalciferol 5,000units/5ml oral solution : 1
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 11
Colecalciferol 2,000units/ml oral drops sugar free : 9
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 20
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 17
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 204
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 9
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 66
Colecalciferol 20,000unit tablets : 3
Colecalciferol 800unit tablets : 25
Colecalciferol 200units/drop oral drops sugar free : 1
Colecalciferol 3,200unit capsules : 8
Colecalciferol 25,000units/1ml soln ud amp sugar free : 5
Colecalciferol 25,000unit tablets : 42
Colecalciferol 2,400units/ml oral drops sugar free : 6
Colecalciferol 20,000unit capsules : 6
Colecalciferol 2,740units/ml oral drops sugar free : 5
Colecalciferol 50,000units/1ml soln ud amp sugar free : 3
Colecalciferol 10,000unit capsules : 1
Colecalciferol 400unit tablets : 4
Colecalciferol 50,000unit capsules : 11
Colecalciferol 400units/ml oral drops sugar free : 1
Pro D3 400unit capsules : 17
Pro D3 1,000unit capsules : 5
Pro D3 2,000units/ml liquid drops : 3
Pro D3 2,000units/ml liquid : 37
Pro D3 800unit capsules : 6
Pro D3 2,000units/ml Vegan liquid drops : 2
Pro D3 2,000units/ml Vegan liquid : 2
Accrete D3 tablets : 403
Valupak Vitamin D3 1,000unit tablets : 4
Adcal-D3 chewable tablets tutti frutti : 237
Adcal-D3 Lemon chewable tablets : 5
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 9
Adcal-D3 750mg/200unit caplets : 849
Calceos 500mg/400unit chewable tablets : 9
Calcichew D3 chewable tablets : 7
Calcichew D3 Forte chewable tablets : 6
SunVit-D3 20,000unit tablets : 3
SunVit-D3 800unit capsules : 4
Fultium-D3 800unit capsules : 482
Fultium-D3 3,200unit capsules : 22
Fultium-D3 2,740units/ml oral drops : 1
Bio-Vitamin D3 1,000unit capsules : 5
Hux D3 20,000unit capsules : 480
Aciferol D3 400unit tablets : 1
Aciferol D3 1,000unit tablets : 168
Aciferol D3 2,200unit tablets : 2
Aciferol D3 3,000unit tablets : 4
Aciferol D3 3,000units/ml liquid : 14
Aciferol D3 2,000units/ml liquid : 6
Desunin 800unit tablets : 57
Evacal D3 1500mg/400unit chewable tablets : 90
Kora LiquiD 3000units/ml oral solution : 6
InVita D3 25,000units/1ml oral solution : 135
InVita D3 50,000units/1ml oral solution : 171
InVita D3 800unit capsules : 32
InVita D3 50,000unit capsules : 11
InVita D3 25,000unit capsules : 136
TheiCal-D3 1000mg/880unit chewable tablets : 8
Stexerol-D3 1,000unit tablets : 26
Stexerol-D3 25,000unit tablets : 1
Calci-D 1000mg/1,000unit chewable tablets : 110
Strivit-D3 800unit capsules : 3
Codeine phosphate 11 Cough suppressants 161 0.07 0.78 0.21 -3.38
Trimethoprim 177 Sulfonamides and trimethoprim 267 0.66 0.87 0.07 -3.08
Insulin aspart 290 Short-acting insulins 549 0.53 0.79 0.09 -3.03
Clopidogrel 886 Antiplatelet drugs 4507 0.20 0.32 0.04 -2.95