Static outliers for Waltham Forest South Leytonstone 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 Waltham Forest South Leytonstone PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Griseofulvin 2 Antifungal preparations 276 0.01 0.00 0.00 22.98
Pyrimethamine 3 Antimalarials 223 0.01 0.00 0.00 22.10
Menthol 2 Lozenges and sprays 2 1.00 0.01 0.09 10.63
Griseofulvin 11 Other antifungals 58 0.19 0.01 0.02 10.52
Disopyramide 14 Drugs for arrhythmias 54 0.26 0.02 0.03 9.44

Prescribing where Waltham Forest South Leytonstone PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Terbinafine hydrochloride 47 Other antifungals 58 0.81 0.99 0.02 -10.52
Dapsone 9 Antileprotic drugs 11 0.82 1.00 0.04 -4.04
Desogestrel 270 Oral progestogen-only contraceptives 323 0.84 0.94 0.03 -3.94
Gamolenic acid 0 Preparations for eczema 8 0.00 0.89 0.29 -3.03
Colecalciferol 4182 Vitamin D 4526 0.92 0.97 0.01 -2.92
Colecalciferol 3,000unit tablets : 26
Colecalciferol 800unit capsules : 100
Colecalciferol 600unit capsules : 3
Colecalciferol 1,000unit tablets : 94
Colecalciferol 1,000unit capsules : 25
Colecalciferol 400unit capsules : 11
Colecalciferol 5,000units/5ml oral solution : 1
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 28
Colecalciferol 2,000units/ml oral drops sugar free : 6
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 7
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 92
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 25
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 1129
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 1
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 64
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 11
Colecalciferol 5,000unit tablets : 2
Colecalciferol 20,000unit tablets : 13
Colecalciferol 800unit tablets : 94
Colecalciferol 40,000unit capsules : 2
Colecalciferol 2,000unit tablets : 1
Colecalciferol 2,000unit orodispersible tablets sugar free : 2
Colecalciferol 3,200unit capsules : 1
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 26
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 1
Colecalciferol 10,000units/ml oral drops sugar free : 10
Colecalciferol 20,000unit capsules : 17
Colecalciferol 2,200unit capsules : 3
Colecalciferol 2,500unit capsules : 1
Colecalciferol 5,000unit capsules : 5
Colecalciferol 4,000unit tablets : 5
Colecalciferol 400unit tablets : 22
Colecalciferol 50,000unit capsules : 1
Colecalciferol 400units/ml oral drops sugar free : 1
Colecalciferol 200units/drop oral drops : 17
Pro D3 400unit capsules : 1
Pro D3 2,000units/ml liquid drops : 3
Pro D3 2,000units/ml Vegan liquid : 1
Accrete D3 tablets : 116
Accrete D3 One a Day 1000mg/880unit chewable tablets : 5
Valupak Vitamin D3 1,000unit tablets : 414
Valupak Vitamin D3 1,000unit capsules : 26
Adcal-D3 chewable tablets tutti frutti : 621
Adcal-D3 Lemon chewable tablets : 32
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 107
Adcal-D3 750mg/200unit caplets : 529
Cacit D3 effervescent granules sachets : 15
Calceos 500mg/400unit chewable tablets : 46
Calcichew D3 chewable tablets : 49
Calcichew D3 Forte chewable tablets : 59
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 4
SunVit-D3 10,000unit tablets : 1
SunVit-D3 20,000unit tablets : 12
SunVit-D3 3,000unit tablets : 1
SunVit-D3 2,000units/ml oral drops : 4
SunVit-D3 400unit tablets : 24
SunVit-D3 800unit tablets : 18
SunVit-D3 10,000unit capsules : 1
SunVit-D3 20,000unit capsules : 6
Fultium-D3 800unit capsules : 28
Fultium-D3 3,200unit capsules : 1
Fultium-D3 2,740units/ml oral drops : 2
Bio-Vitamin D3 5,000unit capsules : 1
Hux D3 20,000unit capsules : 172
Aciferol D3 3,000units/ml liquid : 5
Desunin 800unit tablets : 7
Desunin 4,000unit tablets : 1
Evacal D3 1500mg/400unit chewable tablets : 2
TheiCal-D3 1000mg/880unit chewable tablets : 21