Static outliers for Swb Urban Health 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 Urban Health PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Pyrazinamide 1 Antituberculosis drugs 5 0.20 0.00 0.01 15.91
Sodium bicarbonate 5 Electrolytes and water 13 0.38 0.00 0.03 13.89
Phenylephrine hydrochloride 5 Mydriatics and cycloplegics 24 0.21 0.00 0.02 13.26
Cholera 1 Vaccines and antisera 23 0.04 0.00 0.00 10.54
Ranitidine hydrochloride 30 H2-Receptor antagonists 51 0.59 0.03 0.05 10.16

Prescribing where Swb Urban Health PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Famotidine 13 H2-Receptor antagonists 51 0.25 0.80 0.12 -4.39
Colecalciferol 2126 Vitamin D 2353 0.90 0.97 0.01 -4.36
Colecalciferol 3,000unit tablets : 1
Colecalciferol 800unit capsules : 123
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit tablets : 17
Colecalciferol 1,000unit capsules : 20
Colecalciferol 400unit capsules : 13
Colecalciferol 2,000units/ml oral drops sugar free : 1
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 10
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 30
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 8
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 6
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 10
Colecalciferol 800unit tablets : 38
Colecalciferol 3,200unit capsules : 1
Colecalciferol 25,000units/1ml soln ud amp sugar free : 7
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 3
Colecalciferol 25,000unit tablets : 1
Colecalciferol 2,400units/ml oral drops sugar free : 7
Colecalciferol 20,000unit capsules : 4
Colecalciferol 2,740units/ml oral drops sugar free : 2
Colecalciferol 50,000units/1ml soln ud amp sugar free : 34
Colecalciferol 30,000unit capsules : 10
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 115
Colecalciferol 25,000unit capsules : 4
Colecalciferol 400unit tablets : 5
Colecalciferol 50,000unit capsules : 32
Colecalciferol 200units/drop oral drops : 12
Pro D3 1,000unit capsules : 6
Pro D3 10,000unit capsules : 1
Pro D3 2,000units/ml liquid drops : 1
Pro D3 20,000unit Vegan capsules : 1
Accrete D3 tablets : 127
Adcal-D3 chewable tablets tutti frutti : 178
Adcal-D3 Lemon chewable tablets : 17
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 25
Adcal-D3 750mg/200unit caplets : 172
Cacit D3 effervescent granules sachets : 2
Calceos 500mg/400unit chewable tablets : 18
Calcichew D3 chewable tablets : 37
Calcichew D3 Forte chewable tablets : 14
Fultium-D3 800unit capsules : 94
Fultium-D3 3,200unit capsules : 2
Fultium-D3 20,000unit capsules : 6
Pro D3 forte 3,000units/ml liquid : 7
Hux D3 20,000unit capsules : 146
Desunin 800unit tablets : 37
Evacal D3 1500mg/400unit chewable tablets : 30
HealthAid Vitamin D3 200units/drop oral drops : 1
InVita D3 25,000units/1ml oral solution : 59
InVita D3 50,000units/1ml oral solution : 241
InVita D3 800unit capsules : 69
InVita D3 50,000unit capsules : 72
InVita D3 25,000unit capsules : 6
Stexerol-D3 25,000unit tablets : 1
Thorens 10,000units/ml oral drops : 16
Calci-D 1000mg/1,000unit chewable tablets : 224
Strivit-D3 800unit capsules : 1
Ivermectin 4 Topical preparation for rosacea 10 0.40 0.88 0.12 -4.07
Chlorhexidine gluconate 9 Mouth-washes, gargles and dentifrices 11 0.82 0.98 0.05 -3.35
Co-cyprindiol (Cyprote acetate/ethinylestradiol) 6 Oral preparations for acne 11 0.55 0.96 0.13 -3.21