Static outliers for Derby City 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 Derby City South PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Timolol 177 Beta-adrenoceptor blocking drugs 22317 0.01 0.00 0.00 7.38
Glibenclamide 4 Sulfonylureas 4181 0.00 0.00 0.00 6.58
Lixisenatide 101 Other antidiabetic drugs 5061 0.02 0.00 0.00 4.78
Quinine bisulfate 454 Antimalarials 1045 0.43 0.10 0.08 4.26
Triptorelin acetate 112 Prostate cancer and gonadorelin analogues 579 0.19 0.02 0.05 3.71

Prescribing where Derby City South PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Quinine sulfate 591 Antimalarials 1045 0.57 0.89 0.08 -4.21
Glucose blood testing reagents 3601 Diabetic diagnostic and monitoring agents 4094 0.88 0.94 0.02 -2.85
OneTouch Select Plus testing strips : 9
FreeStyle Optium testing strips : 148
GlucoMen LX Sensor testing strips : 3
GlucoMen areo Sensor testing strips : 515
Active testing strips : 5
FreeStyle testing strips : 8
FreeStyle Lite testing strips : 13
Aviva testing strips : 163
WaveSense JAZZ testing strips : 2130
WaveSense JAZZ Duo testing strips : 6
Contour testing strips : 42
CareSens N testing strips : 3
Mylife Pura testing strips : 3
Mobile cassette : 98
GlucoRx Q testing strips : 4
GlucoRx Nexus testing strips : 246
GlucoRx HCT Glucose testing strips : 4
Omnitest 5 testing strips : 1
Element testing strips : 2
Contour Next testing strips : 76
TEE2 testing strips : 48
Dario testing strips : 9
Contour TS testing strips : 19
Performa testing strips : 7
Finetest Lite testing strips : 3
palmdoc testing strips : 2
CareSens PRO testing strips : 15
True Metrix testing strips : 1
4SURE testing strips : 1
Contour Plus testing strips : 1
Kinetik Wellbeing testing strips : 1
Guide testing strips : 15
Indapamide 936 Thiazides and related diuretics 6734 0.14 0.42 0.10 -2.77
Co-codamol (Codeine phosphate/paracetamol) 3769 Non-opioid analgesics and compound preparations 18944 0.20 0.44 0.12 -1.98
Oxycodone hydrochloride 299 Opioid analgesics 18184 0.02 0.08 0.03 -1.98
Oxycodone 5mg/5ml oral solution sugar free : 11
Oxycodone 10mg/ml oral solution sugar free : 3
Oxycodone 5mg modified-release tablets : 5
Oxycodone 10mg/1ml solution for injection ampoules : 24
Oxycodone 50mg/1ml solution for injection ampoules : 5
OxyContin 10mg modified-release tablets : 5
OxyContin 40mg modified-release tablets : 5
Longtec 5mg modified-release tablets : 11
Longtec 10mg modified-release tablets : 45
Longtec 20mg modified-release tablets : 43
Longtec 40mg modified-release tablets : 17
Longtec 15mg modified-release tablets : 6
Shortec 5mg capsules : 44
Shortec 10mg capsules : 21
Shortec 20mg capsules : 5
Shortec liquid 1mg/ml oral solution : 11
Oxypro 5mg modified-release tablets : 7
Oxypro 10mg modified-release tablets : 15
Oxypro 20mg modified-release tablets : 7
Oxypro 30mg modified-release tablets : 3
Oxypro 40mg modified-release tablets : 6