Static outliers for Eastbourne East 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 Eastbourne East PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Oxitriptan 2 Other antidepressant drugs 6197 0.00 0.00 0.00 11.97
Diethylamine salicylate 554 Rubefacients, topical NSAIDS, capsaicin and poultice 1499 0.37 0.03 0.04 8.35
Flunarizine dihydrochloride 12 Drugs used in nausea and vertigo 2454 0.00 0.00 0.00 5.40
Benzalkonium chloride 16 Barrier preparations 34 0.47 0.05 0.08 5.18
Compound antispasmodic preparations 1 Antispasmodic and other drugs altering gut motility 1515 0.00 0.00 0.00 5.09

Prescribing where Eastbourne East PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Baclofen 255 Skeletal muscle relaxants 658 0.39 0.81 0.12 -3.57
Glucose 27 Treatment of hypoglycaemia 54 0.50 0.77 0.09 -2.96
Mupirocin 1 Antibacterial preparations only used topically 7 0.14 0.67 0.23 -2.28
Beclometasone dipropionate 2445 Corticosteroids (respiratory) 6570 0.37 0.56 0.10 -1.99
Beclometasone 50micrograms/dose inhaler CFC free : 32
Beclometasone 100micrograms/dose inhaler CFC free : 68
Beclometasone 100mcg/dose breath actuated inhaler CFC free : 1
Beclometasone 200micrograms/dose dry powder inhaler : 3
Beclometasone 200micrograms/dose inhaler CFC free : 3
Beclometasone 100microg/Formoterol 6microg/dose inh CFCfree : 24
Beclometasone 100microg/Formoterol 6microg/dose dry pdr inh : 3
Beclometasone 200microg/Formoterol 6microg/dose inh CFC free : 2
Beclometasone 200microg/Formoterol 6microg/dose dry pdr inh : 5
Qvar 50 inhaler : 134
Qvar 100 inhaler : 237
Qvar 50 Autohaler : 15
Qvar 100 Autohaler : 49
Qvar 50micrograms/dose Easi-Breathe inhaler : 4
Qvar 100micrograms/dose Easi-Breathe inhaler : 12
Easyhaler Beclometasone 200micrograms/dose dry pdr inhaler : 1
Clenil Modulite 50micrograms/dose inhaler : 254
Clenil Modulite 100micrograms/dose inhaler : 844
Clenil Modulite 200micrograms/dose inhaler : 217
Clenil Modulite 250micrograms/dose inhaler : 25
Fostair 100micrograms/dose / 6micrograms/dose inhaler : 298
Fostair 200micrograms/dose / 6micrograms/dose inhaler : 163
Fostair NEXThaler 100microg/dose / 6microg/dose dry pdr inh : 19
Fostair NEXThaler 200microg/dose / 6microg/dose dry pdr inh : 14
Kelhale 50micrograms/dose inhaler : 6
Kelhale 100micrograms/dose inhaler : 5
Soprobec 50micrograms/dose inhaler : 3
Soprobec 200micrograms/dose inhaler : 1
Soprobec 100micrograms/dose inhaler : 3
Cocois 4 Preparations for psoriasis 313 0.01 0.06 0.03 -1.96