Static outliers for Parkwood 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 Parkwood PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Paricalcitol 6 Vitamin D 5482 0.00 0.00 0.00 9.50
Ergocalciferol 160 Vitamin D 5482 0.03 0.00 0.00 8.46
Sodium oxybate 9 Hypnotics 1745 0.01 0.00 0.00 7.47
Sterculia 200 Bulk-forming laxatives 621 0.32 0.04 0.04 6.45
Iron and folic acid 29 Oral iron 1594 0.02 0.00 0.00 5.82

Prescribing where Parkwood PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ispaghula husk 421 Bulk-forming laxatives 621 0.68 0.96 0.04 -6.35
Procyclidine hydrochloride 48 Antimuscarinic drugs used in parkinsonism 92 0.52 0.85 0.11 -3.07
Colecalciferol 5093 Vitamin D 5482 0.93 0.97 0.01 -2.56
Colecalciferol 800unit capsules : 783
Colecalciferol 1,000unit tablets : 55
Colecalciferol 1,000unit capsules : 6
Colecalciferol 400unit capsules : 4
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 1
Colecalciferol 2,000units/ml oral drops sugar free : 2
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 7
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 35
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 141
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 28
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 39
Colecalciferol 10,000unit tablets : 1
Colecalciferol 800unit tablets : 14
Colecalciferol 3,200unit capsules : 33
Colecalciferol 25,000units/1ml soln ud amp sugar free : 3
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 23
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 5
Colecalciferol 2,400units/ml oral drops sugar free : 8
Colecalciferol 20,000unit capsules : 1
Colecalciferol 4,000unit tablets : 1
Colecalciferol 25,000unit capsules : 15
Colecalciferol 400unit tablets : 29
Colecalciferol 50,000unit capsules : 4
Pro D3 1,000unit capsules : 4
Pro D3 2,000units/ml liquid drops : 2
Accrete D3 tablets : 281
Accrete D3 One a Day 1000mg/880unit chewable tablets : 12
Adcal-D3 chewable tablets tutti frutti : 804
Adcal-D3 Lemon chewable tablets : 56
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 54
Adcal-D3 750mg/200unit caplets : 1255
Cacit D3 effervescent granules sachets : 1
Calceos 500mg/400unit chewable tablets : 57
Calcichew D3 chewable tablets : 14
Calcichew D3 Forte chewable tablets : 63
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 3
Calfovit D3 oral powder sachets : 5
SunVit-D3 800unit tablets : 6
Fultium-D3 800unit capsules : 355
Fultium-D3 3,200unit capsules : 2
Aciferol D3 3,000units/ml liquid : 1
Aciferol D3 2,000units/ml liquid : 5
Desunin 800unit tablets : 5
Evacal D3 1500mg/400unit chewable tablets : 675
InVita D3 25,000units/1ml oral solution : 47
InVita D3 50,000units/1ml oral solution : 25
InVita D3 800unit capsules : 54
InVita D3 50,000unit capsules : 64
InVita D3 25,000unit capsules : 5
Co-amilofruse (Amiloride hydrochloride/frusemide) 16 Potassium sparing diuretics and compounds 74 0.22 0.70 0.19 -2.56
Salicylic acid 4 Preparations for warts and calluses 23 0.17 0.67 0.21 -2.35