Static outliers for Swb Modality 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 Swb Modality PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Etanercept 1 Rheumatic disease suppressant drugs 807 0.0 0.0 0.00 19.62
Adalimumab 1 Rheumatic disease suppressant drugs 807 0.0 0.0 0.00 8.64
Baricitinib 2 Rheumatic disease suppressant drugs 807 0.0 0.0 0.00 7.23
Sodium polystyrene sulfonate 4 Oral potassium 40 0.1 0.0 0.01 7.05
Nicotinates 12 Rubefacients, topical NSAIDS, capsaicin and poultice 3311 0.0 0.0 0.00 6.39

Prescribing where Swb Modality PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 6718 Vitamin D 7380 0.91 0.97 0.01 -3.89
Colecalciferol 3,000unit tablets : 2
Colecalciferol 800unit capsules : 174
Colecalciferol 1,000unit tablets : 25
Colecalciferol 1,000unit capsules : 19
Colecalciferol 400unit capsules : 4
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 22
Colecalciferol 2,000units/ml oral drops sugar free : 2
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 35
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 121
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 4
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 848
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 13
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 91
Colecalciferol 400unit / Calcium carbonate 1.25g tablets : 6
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 275
Colecalciferol 5,000unit tablets : 5
Colecalciferol 10,000unit tablets : 1
Colecalciferol 20,000unit tablets : 3
Colecalciferol 800unit tablets : 62
Colecalciferol 10,000units/5ml oral solution : 1
Colecalciferol 50,000unit tablets : 10
Colecalciferol 3,200unit capsules : 12
Colecalciferol 25,000units/1ml soln ud amp sugar free : 10
Colecalciferol 25,000unit tablets : 1
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 12
Colecalciferol 10,000units/ml oral drops sugar free : 3
Colecalciferol 10,000units/ml oral solution sugar free : 3
Colecalciferol 2,400units/ml oral drops sugar free : 2
Colecalciferol 20,000unit capsules : 25
Colecalciferol 50,000units/1ml soln ud amp sugar free : 1
Colecalciferol 30,000unit capsules : 6
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 6
Colecalciferol 5,600unit capsules : 1
Colecalciferol 25,000unit capsules : 20
Colecalciferol 400unit tablets : 36
Colecalciferol 50,000unit capsules : 23
Colecalciferol 2,000unit chewable tablets : 1
Colecalciferol 400units/ml oral drops sugar free : 3
Pro D3 400unit capsules : 1
Pro D3 20,000unit capsules : 6
Pro D3 2,000units/ml liquid : 2
Accrete D3 tablets : 705
Accrete D3 One a Day 1000mg/880unit chewable tablets : 7
Adcal-D3 chewable tablets tutti frutti : 927
Adcal-D3 Lemon chewable tablets : 148
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 60
Adcal-D3 750mg/200unit caplets : 1351
Cacit D3 effervescent granules sachets : 6
Calceos 500mg/400unit chewable tablets : 19
Calcichew D3 chewable tablets : 13
Calcichew D3 Forte chewable tablets : 67
Calfovit D3 oral powder sachets : 20
Natecal D3 600mg/400unit chewable tablets : 12
SunVit-D3 10,000unit tablets : 3
Fultium-D3 800unit capsules : 140
Fultium-D3 3,200unit capsules : 11
Fultium-D3 20,000unit capsules : 216
Fultium-D3 2,740units/ml oral drops : 5
Pro D3 forte 3,000units/ml liquid : 1
Hux D3 20,000unit capsules : 89
E-D3 10,000units/ml oral solution : 1
Desunin 800unit tablets : 8
Desunin 4,000unit tablets : 1
Evacal D3 1500mg/400unit chewable tablets : 9
InVita D3 25,000units/1ml oral solution : 89
InVita D3 2,400units/ml oral drops : 7
InVita D3 50,000units/1ml oral solution : 55
InVita D3 800unit capsules : 45
InVita D3 400unit capsules : 1
InVita D3 50,000unit capsules : 389
InVita D3 25,000unit capsules : 36
InVita D3 5,600unit capsules : 1
TheiCal-D3 1000mg/880unit chewable tablets : 1
Thorens 10,000units/ml oral drops : 7
Calci-D 1000mg/1,000unit chewable tablets : 370
Strivit-D3 800unit capsules : 1
Co-cyprindiol (Cyprote acetate/ethinylestradiol) 5 Oral preparations for acne 10 0.50 0.96 0.13 -3.56
Alfentanil hydrochloride 0 Opioid analgesics 2 0.00 0.85 0.34 -2.49
Calcipotriol 434 Preparations for psoriasis 564 0.77 0.87 0.04 -2.30
Tamoxifen citrate 36 Breast cancer 393 0.09 0.27 0.08 -2.29