Static outliers for Three Harbours And Bosvena 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 Three Harbours And Bosvena PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Prilocaine hydrochloride 11 Local anaesthetics 505 0.02 0.0 0.0 15.33
Estradiol valandestradiol valerate with dienogest 31 Combined hormonal contraceptives 1291 0.02 0.0 0.0 8.29
Insulin human 2 Short-acting insulins 922 0.00 0.0 0.0 5.71
Trimetazidine hydrochloride 10 Calcium-channel blockers 18243 0.00 0.0 0.0 5.48
Low protein snacks 2 Foods for special diets 194 0.01 0.0 0.0 4.66

Prescribing where Three Harbours And Bosvena PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Prucalopride 1 Other drugs used in constipation 14 0.07 0.73 0.19 -3.48
Alcohol 0 Alcohols and saline 1 0.00 0.86 0.34 -2.54
Colecalciferol 6276 Vitamin D 6734 0.93 0.97 0.01 -2.35
Colecalciferol 800unit capsules : 584
Colecalciferol 1,000unit tablets : 72
Colecalciferol 1,000unit capsules : 36
Colecalciferol 400unit capsules : 76
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 9
Colecalciferol 2,000units/ml oral drops sugar free : 2
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 51
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 282
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 4
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 483
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 4
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 17
Colecalciferol 5,000unit tablets : 2
Colecalciferol 20,000unit tablets : 1
Colecalciferol 800unit tablets : 58
Colecalciferol 40,000unit capsules : 5
Colecalciferol 50,000unit tablets : 5
Colecalciferol 2,000unit tablets : 29
Colecalciferol 3,200unit capsules : 16
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 9
Colecalciferol 25,000unit tablets : 5
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 1
Colecalciferol 10,000units/ml oral drops sugar free : 4
Colecalciferol 2,400units/ml oral drops sugar free : 3
Colecalciferol 20,000unit capsules : 59
Colecalciferol 2,740units/ml oral drops sugar free : 11
Colecalciferol 5,000unit capsules : 2
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 6
Colecalciferol 4,000unit tablets : 5
Colecalciferol 25,000unit capsules : 1
Colecalciferol 400unit tablets : 48
Colecalciferol 50,000unit capsules : 5
BabyD 1,000units/ml oral solution : 1
Pro D3 2,000units/ml liquid drops : 2
Accrete D3 tablets : 53
Adcal-D3 chewable tablets tutti frutti : 1042
Adcal-D3 Lemon chewable tablets : 62
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 20
Adcal-D3 750mg/200unit caplets : 835
Cacit D3 effervescent granules sachets : 8
Calceos 500mg/400unit chewable tablets : 724
Calcichew D3 chewable tablets : 72
Calcichew D3 Forte chewable tablets : 945
Calcichew D3 500mg/400unit caplets : 1
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 3
Calfovit D3 oral powder sachets : 13
Natecal D3 600mg/400unit chewable tablets : 11
SunVit-D3 1,000unit tablets : 5
SunVit-D3 800unit tablets : 6
Fultium-D3 800unit capsules : 411
Fultium-D3 3,200unit capsules : 5
Fultium-D3 20,000unit capsules : 11
Fultium-D3 2,740units/ml oral drops : 12
Aciferol D3 400unit tablets : 1
Desunin 800unit tablets : 9
Evacal D3 1500mg/400unit chewable tablets : 15
Vitamin D3 High Strength 5,000unit tablets : 3
Kora LiquiD 3000units/ml oral solution : 2
InVita D3 25,000units/1ml oral solution : 2
InVita D3 2,400units/ml oral drops : 1
InVita D3 50,000unit capsules : 1
InVita D3 25,000unit capsules : 6
TheiCal-D3 1000mg/880unit chewable tablets : 47
Stexerol-D3 1,000unit tablets : 28
Stexerol-D3 25,000unit tablets : 1
Thorens 10,000units/ml oral drops : 1
Calci-D 1000mg/1,000unit chewable tablets : 19
Strivit-D3 800unit capsules : 1
ColeDose D3 5,000unit tablets : 1
ColeDose D3 50,000unit capsules : 1
Ramipril 7479 Angiotensin-converting enzyme inhibitors 19116 0.39 0.69 0.14 -2.21
Tamoxifen citrate 114 Breast cancer 936 0.12 0.27 0.08 -1.90