Static outliers for Brent South Kwh 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 Brent South Kwh PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Aluminium acetate 1 Otitis externa 388 0.00 0.0 0.0 33.71
Flutamide 20 Prostate cancer and gonadorelin analogues 296 0.07 0.0 0.0 23.38
Zoledronic acid 1 Bisphosphonates and other drugs 1532 0.00 0.0 0.0 8.84
Perindopril with calcium channel blocker 2 Angiotensin-converting enzyme inhibitors 10528 0.00 0.0 0.0 8.48
Paracetamol and ibuprofen 2 Non-opioid analgesics and compound preparations 6576 0.00 0.0 0.0 8.11

Prescribing where Brent South Kwh PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Water for injection 7 Electrolytes and water 30 0.23 0.81 0.17 -3.46
Theophylline 63 Theophylline 158 0.40 0.84 0.15 -2.97
Famotidine 94 H2-Receptor antagonists 217 0.43 0.80 0.12 -2.95
Colecalciferol 8537 Vitamin D 9243 0.92 0.97 0.01 -2.94
Colecalciferol 3,000unit tablets : 20
Colecalciferol 800unit capsules : 134
Colecalciferol 20,000units/5ml oral suspension : 1
Colecalciferol 1,000unit tablets : 150
Colecalciferol 1,000unit capsules : 51
Colecalciferol 400unit capsules : 4
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 46
Colecalciferol 2,000units/ml oral drops sugar free : 23
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 41
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 458
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 23
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 740
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 7
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 96
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 156
Colecalciferol 10,000unit tablets : 3
Colecalciferol 20,000unit tablets : 17
Colecalciferol 800unit tablets : 29
Colecalciferol 2,000unit tablets : 7
Colecalciferol 3,200unit capsules : 3
Colecalciferol 25,000units/1ml soln ud amp sugar free : 3
Colecalciferol 25,000unit tablets : 1
Colecalciferol 10,000units/ml oral drops sugar free : 4
Colecalciferol 2,400units/ml oral drops sugar free : 10
Colecalciferol 20,000unit capsules : 80
Colecalciferol 2,740units/ml oral drops sugar free : 4
Colecalciferol 5,000unit capsules : 1
Colecalciferol 4,000unit tablets : 5
Colecalciferol 25,000unit capsules : 1
Colecalciferol 200units/drop oral drops : 4
Solgar Vitamin D3 1,000unit tablets : 2
Solgar Vitamin D3 400unit capsules : 1
Pro D3 400unit capsules : 1
Pro D3 1,000unit capsules : 4
Pro D3 10,000unit capsules : 2
Pro D3 20,000unit capsules : 8
Pro D3 2,000units/ml liquid drops : 8
Pro D3 2,000units/ml liquid : 9
Accrete D3 tablets : 587
Accrete D3 One a Day 1000mg/880unit chewable tablets : 7
Valupak Vitamin D3 1,000unit tablets : 37
Adcal-D3 chewable tablets tutti frutti : 861
Adcal-D3 Lemon chewable tablets : 78
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 28
Adcal-D3 750mg/200unit caplets : 495
Cacit D3 effervescent granules sachets : 1
Calceos 500mg/400unit chewable tablets : 517
Calcichew D3 chewable tablets : 72
Calcichew D3 Forte chewable tablets : 149
Calfovit D3 oral powder sachets : 10
Natecal D3 600mg/400unit chewable tablets : 4
SunVit-D3 1,000unit tablets : 9
SunVit-D3 20,000unit tablets : 2
SunVit-D3 2,000unit tablets : 7
SunVit-D3 400unit capsules : 10
SunVit-D3 10,000unit capsules : 3
SunVit-D3 800unit capsules : 79
SunVit-D3 1,000unit Vegan tablets : 1
SunVit-D3 1,000unit capsules : 5
SunVit-D3 20,000unit capsules : 1
Fultium-D3 800unit capsules : 1402
Fultium-D3 3,200unit capsules : 4
Fultium-D3 20,000unit capsules : 204
Fultium-D3 2,740units/ml oral drops : 1
Pro D3 forte 3,000units/ml liquid : 10
Bio-Vitamin D3 800unit capsules : 1
Bio-Vitamin D3 5,000unit capsules : 4
Hux D3 20,000unit capsules : 40
Aciferol D3 3,000units/ml liquid : 1
Desunin 800unit tablets : 66
Plenachol D3 20,000unit capsules : 30
Plenachol D3 40,000unit capsules : 12
Evacal D3 1500mg/400unit chewable tablets : 8
HealthAid Vitamin D3 200units/drop oral drops : 1
Kora LiquiD 3000units/ml oral solution : 1
InVita D3 25,000units/1ml oral solution : 96
InVita D3 2,400units/ml oral drops : 2
InVita D3 50,000units/1ml oral solution : 11
InVita D3 800unit capsules : 174
InVita D3 50,000unit capsules : 8
Stexerol-D3 1,000unit tablets : 979
Stexerol-D3 25,000unit tablets : 93
Thorens 10,000units/ml oral drops : 16
Thorens 25,000units/2.5ml oral solution : 10
Calci-D 1000mg/1,000unit chewable tablets : 243
Desogestrel 445 Oral progestogen-only contraceptives 507 0.88 0.94 0.03 -2.37