Static outliers for Swb I3 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 I3 PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Tadalafil (Vasodilator Antihypertensive) 2 Vasodilator antihypertensive drugs 202 0.01 0.00 0.00 35.31
Meningococcal A + C + W135 + Y vaccine 28 Vaccines and antisera 281 0.10 0.00 0.01 11.98
Atomoxetine hydrochloride 26 CNS Stimulants and drugs used for ADHD 54 0.48 0.08 0.05 7.85
Co-phenotrope (Diphenox hydrochloride/atropine sulfate) 5 Antimotility drugs 279 0.02 0.00 0.00 6.52
Griseofulvin 10 Other antifungals 89 0.11 0.01 0.02 6.06

Prescribing where Swb I3 PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Terbinafine hydrochloride 79 Other antifungals 89 0.89 0.99 0.02 -6.06
Colecalciferol 5699 Vitamin D 6331 0.90 0.97 0.01 -4.60
Colecalciferol 3,000unit tablets : 7
Colecalciferol 800unit capsules : 166
Colecalciferol 1,000unit tablets : 55
Colecalciferol 1,000unit capsules : 23
Colecalciferol 400unit capsules : 27
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 1
Colecalciferol 2,000units/ml oral drops sugar free : 14
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 25
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 62
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 9
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 318
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 3
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 46
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 206
Colecalciferol 20,000unit tablets : 9
Colecalciferol 800unit tablets : 74
Colecalciferol 50,000unit tablets : 1
Colecalciferol 2,000unit tablets : 14
Colecalciferol 2,000unit orodispersible tablets sugar free : 2
Colecalciferol 3,200unit capsules : 2
Colecalciferol 25,000units/1ml soln ud amp sugar free : 11
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 2
Colecalciferol 10,000units/ml oral drops sugar free : 5
Colecalciferol 10,000units/ml oral solution sugar free : 1
Colecalciferol 2,400units/ml oral drops sugar free : 4
Colecalciferol 20,000unit capsules : 1
Colecalciferol 2,740units/ml oral drops sugar free : 1
Colecalciferol 50,000units/1ml soln ud amp sugar free : 16
Colecalciferol 10,000unit capsules : 9
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 1
Colecalciferol 4,000unit tablets : 1
Colecalciferol 5,600unit capsules : 11
Colecalciferol 25,000unit capsules : 16
Colecalciferol 400unit tablets : 24
Colecalciferol 50,000unit capsules : 99
Colecalciferol 400units/ml oral drops sugar free : 2
Colecalciferol 200units/drop oral drops : 1
Pro D3 1,000unit capsules : 9
Pro D3 10,000unit capsules : 5
Pro D3 20,000unit capsules : 3
Pro D3 2,000units/ml liquid drops : 14
Pro D3 2,000units/ml liquid : 9
Pro D3 3,200unit Vegan capsules : 1
Accrete D3 tablets : 521
Accrete D3 One a Day 1000mg/880unit chewable tablets : 12
Valupak Vitamin D3 1,000unit tablets : 2
Adcal-D3 chewable tablets tutti frutti : 506
Adcal-D3 Lemon chewable tablets : 25
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 44
Adcal-D3 750mg/200unit caplets : 1394
Calceos 500mg/400unit chewable tablets : 75
Calcichew D3 chewable tablets : 26
Calcichew D3 Forte chewable tablets : 17
SunVit-D3 10,000unit tablets : 1
SunVit-D3 20,000unit tablets : 1
SunVit-D3 3,000units/ml oral solution : 1
Fultium-D3 800unit capsules : 67
Fultium-D3 3,200unit capsules : 16
Fultium-D3 20,000unit capsules : 97
Fultium-D3 2,740units/ml oral drops : 1
Pro D3 forte 3,000units/ml liquid : 4
Bio-Vitamin D3 800unit capsules : 13
Bio-Vitamin D3 1,000unit capsules : 51
Bio-Vitamin D3 5,000unit capsules : 4
Hux D3 20,000unit capsules : 88
Aciferol D3 2,000units/ml liquid : 1
Desunin 800unit tablets : 10
Evacal D3 1500mg/400unit chewable tablets : 9
InVita D3 25,000units/1ml oral solution : 227
InVita D3 2,400units/ml oral drops : 8
InVita D3 50,000units/1ml oral solution : 387
InVita D3 800unit capsules : 145
InVita D3 50,000unit capsules : 271
InVita D3 25,000unit capsules : 13
InVita D3 5,600unit capsules : 12
TheiCal-D3 1000mg/880unit chewable tablets : 8
Stexerol-D3 1,000unit tablets : 23
Stexerol-D3 25,000unit tablets : 1
Thorens 10,000units/ml oral drops : 5
Calci-D 1000mg/1,000unit chewable tablets : 290
Strivit-D3 800unit capsules : 3
ColeDose D3 25,000unit capsules : 3
ColeDose D3 50,000unit capsules : 7
Memantine hydrochloride 4 Drugs for dementia 127 0.03 0.38 0.11 -2.99
Methylphenidate hydrochloride 19 CNS Stimulants and drugs used for ADHD 54 0.35 0.66 0.11 -2.87
Loperamide hydrochloride 274 Antimotility drugs 279 0.98 1.00 0.01 -2.83