Static outliers for North Southall 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 North Southall PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Salbutamol 38 Compound bronchodilator preparations 99 0.38 0.01 0.02 15.69
Raloxifene hydrochloride 44 Oestrogens and Hormone Replacement Therapy 281 0.16 0.01 0.01 11.84
Tazarotene 3 Preparations for psoriasis 473 0.01 0.00 0.00 9.10
Moxifloxacin 38 Quinolones 225 0.17 0.01 0.02 8.26
Modafinil 35 CNS Stimulants and drugs used for ADHD 75 0.47 0.06 0.05 7.58

Prescribing where North Southall PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Furosemide 3288 Loop diuretics 5545 0.59 0.85 0.07 -3.69
Desogestrel 190 Oral progestogen-only contraceptives 224 0.85 0.94 0.03 -3.48
Methylphenidate hydrochloride 23 CNS Stimulants and drugs used for ADHD 75 0.31 0.66 0.11 -3.29
Trimethoprim 248 Sulfonamides and trimethoprim 359 0.69 0.87 0.07 -2.66
Colecalciferol 12090 Vitamin D 13027 0.93 0.97 0.01 -2.63
Colecalciferol 3,000unit tablets : 2
Colecalciferol 800unit capsules : 125
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit tablets : 100
Colecalciferol 1,000unit capsules : 60
Colecalciferol 400unit capsules : 3
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 58
Colecalciferol 2,000units/ml oral drops sugar free : 4
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 24
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 31
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 477
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 8
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 8
Colecalciferol 400unit / Calcium carbonate 1.25g tablets : 2
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 29
Colecalciferol 400units/dose oral spray sugar free : 1
Colecalciferol 5,000unit tablets : 3
Colecalciferol 20,000unit tablets : 26
Colecalciferol 800unit tablets : 17
Colecalciferol 40,000unit capsules : 16
Colecalciferol 50,000unit tablets : 1
Colecalciferol 2,000unit tablets : 21
Colecalciferol 3,200unit capsules : 2
Colecalciferol 25,000units/1ml soln ud amp sugar free : 49
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 2
Colecalciferol 10,000units/ml oral solution sugar free : 1
Colecalciferol 20,000unit capsules : 135
Colecalciferol 15,000units/5ml oral solution : 4
Colecalciferol 50,000units/1ml soln ud amp sugar free : 1
Colecalciferol 2,500unit capsules : 3
Colecalciferol 4,000unit tablets : 1
Colecalciferol 25,000unit capsules : 1
Colecalciferol 400unit tablets : 21
Pro D3 400unit capsules : 27
Pro D3 1,000unit capsules : 5
Pro D3 2,500unit capsules : 6
Pro D3 10,000unit capsules : 5
Pro D3 20,000unit capsules : 11
Pro D3 2,000units/ml liquid drops : 15
Pro D3 2,000units/ml liquid : 3
Lamberts Vitamin D3 400unit tablets : 2
Accrete D3 tablets : 451
Valupak Vitamin D3 1,000unit tablets : 62
Adcal-D3 chewable tablets tutti frutti : 421
Adcal-D3 Lemon chewable tablets : 60
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 127
Adcal-D3 750mg/200unit caplets : 2064
Cacit D3 effervescent granules sachets : 1
Calceos 500mg/400unit chewable tablets : 1518
Calcichew D3 chewable tablets : 46
Calcichew D3 Forte chewable tablets : 277
Calcichew D3 500mg/400unit caplets : 6
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 5
Calfovit D3 oral powder sachets : 4
Natecal D3 600mg/400unit chewable tablets : 3
SunVit-D3 1,000unit tablets : 55
SunVit-D3 10,000unit tablets : 8
SunVit-D3 20,000unit tablets : 159
SunVit-D3 2,000unit tablets : 39
SunVit-D3 5,000unit tablets : 1
SunVit-D3 400unit tablets : 5
SunVit-D3 800unit tablets : 4
Fultium-D3 800unit capsules : 2449
Fultium-D3 3,200unit capsules : 36
Fultium-D3 20,000unit capsules : 761
Fultium-D3 2,740units/ml oral drops : 2
Pro D3 forte 3,000units/ml liquid : 1
Hux D3 20,000unit capsules : 992
Desunin 800unit tablets : 239
Plenachol D3 20,000unit capsules : 27
Plenachol D3 40,000unit capsules : 151
OsteoCaps D3 20,000unit capsules : 18
OsteoCaps D3 1,000unit capsules : 50
Evacal D3 1500mg/400unit chewable tablets : 4
InVita D3 25,000units/1ml oral solution : 302
InVita D3 2,400units/ml oral drops : 81
InVita D3 50,000units/1ml oral solution : 2
InVita D3 800unit capsules : 1
InVita D3 50,000unit capsules : 2
InVita D3 25,000unit capsules : 1
InVita D3 5,600unit capsules : 20
TheiCal-D3 1000mg/880unit chewable tablets : 1
Stexerol-D3 1,000unit tablets : 125
Stexerol-D3 25,000unit tablets : 147
Thorens 10,000units/ml oral drops : 2
Calci-D 1000mg/1,000unit chewable tablets : 48
ColeDose D3 20,000unit tablets : 1