Static outliers for Childwall & Wavertree 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 Childwall & Wavertree PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Dextromethorphan hydrobromide 6 Cough suppressants 24 0.25 0.01 0.04 6.11
Ciprofloxacin 41 Otitis externa 473 0.09 0.01 0.02 4.70
Erythromycin stearate 18 Macrolides 736 0.02 0.00 0.00 4.67
Apomorphine hydrochloride 27 Dopaminergic drugs used in parkinsonism 1205 0.02 0.00 0.00 4.66
Liothyronine sodium 68 Thyroid hormones 7763 0.01 0.00 0.00 4.09

Prescribing where Childwall & Wavertree PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Levothyroxine sodium 7695 Thyroid hormones 7763 0.99 1.00 0.00 -3.94
Vitamin A 2 Vitamin A 21 0.10 0.83 0.30 -2.43
Midazolam hydrochloride 15 Drugs used in status epilepticus 41 0.37 0.79 0.18 -2.29
Colecalciferol 8235 Vitamin D 8825 0.93 0.97 0.01 -2.27
Colecalciferol 3,000unit tablets : 1
Colecalciferol 800unit capsules : 257
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit capsules : 8
Colecalciferol 400unit capsules : 53
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 5
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 59
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 647
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 15
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 302
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 24
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 26
Colecalciferol 20,000unit tablets : 22
Colecalciferol 800unit tablets : 24
Colecalciferol 40,000unit capsules : 2
Colecalciferol 2,000unit tablets : 2
Colecalciferol 25,000units/1ml soln ud amp sugar free : 7
Colecalciferol 25,000unit tablets : 3
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 4
Colecalciferol 10,000units/ml oral drops sugar free : 2
Colecalciferol 10,000units/ml oral solution sugar free : 4
Colecalciferol 20,000unit capsules : 359
Colecalciferol 2,740units/ml oral drops sugar free : 1
Colecalciferol 5,000unit capsules : 8
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 2
Colecalciferol 25,000unit capsules : 9
Colecalciferol 400unit tablets : 17
Colecalciferol 50,000unit capsules : 3
Colecalciferol 400units/ml oral drops sugar free : 1
Colecalciferol 200units/drop oral drops : 7
Pro D3 400unit capsules : 4
Pro D3 1,000unit capsules : 3
Pro D3 10,000unit capsules : 10
Pro D3 20,000unit capsules : 225
Pro D3 20,000unit Vegan capsules : 3
Accrete D3 tablets : 27
Accrete D3 One a Day 1000mg/880unit chewable tablets : 4
Adcal-D3 chewable tablets tutti frutti : 124
Adcal-D3 Lemon chewable tablets : 66
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 20
Adcal-D3 750mg/200unit caplets : 586
Cacit D3 effervescent granules sachets : 21
Calceos 500mg/400unit chewable tablets : 61
Calcichew D3 chewable tablets : 77
Calcichew D3 Forte chewable tablets : 1175
Calfovit D3 oral powder sachets : 6
Natecal D3 600mg/400unit chewable tablets : 36
SunVit-D3 10,000unit tablets : 1
SunVit-D3 20,000unit tablets : 1
SunVit-D3 800unit tablets : 3
SunVit-D3 2,200unit capsules : 3
SunVit-D3 800unit capsules : 9
Fultium-D3 800unit capsules : 785
Fultium-D3 3,200unit capsules : 3
Fultium-D3 20,000unit capsules : 1557
Fultium-D3 2,740units/ml oral drops : 1
Bio-Vitamin D3 20,000unit capsules : 4
Hux D3 20,000unit capsules : 26
Desunin 800unit tablets : 15
OsteoCaps D3 20,000unit capsules : 5
Evacal D3 1500mg/400unit chewable tablets : 1367
HealthAid Vitamin D3 200units/drop oral drops : 4
InVita D3 25,000units/1ml oral solution : 44
InVita D3 2,400units/ml oral drops : 1
InVita D3 800unit capsules : 24
InVita D3 400unit capsules : 6
InVita D3 50,000unit capsules : 3
InVita D3 25,000unit capsules : 18
Stexerol-D3 1,000unit tablets : 4
Stexerol-D3 25,000unit tablets : 1
Thorens 10,000units/ml oral drops : 5
Thorens 25,000units/2.5ml oral solution : 1
Vitamin D3 400units/ml for infants and children dps : 1
Calci-D 1000mg/1,000unit chewable tablets : 20
Codeine phosphate 9 Cough suppressants 24 0.38 0.78 0.21 -1.92