Static outliers for Great West Road 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 Great West Road PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Dydrogesterone 1 Progestogens and progesterone receptor modulators 196 0.01 0.00 0.00 28.31
Pitolisant hydrochloride 10 CNS Stimulants and drugs used for ADHD 195 0.05 0.00 0.00 25.30
Demeclocycline hydrochloride 51 Tetracyclines 874 0.06 0.00 0.00 14.88
Moxifloxacin 20 Quinolones 107 0.19 0.01 0.02 9.18
Raltegravir 1 HIV infection 2 0.50 0.01 0.08 6.37

Prescribing where Great West Road PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Vitamin A 0 Vitamin A 33 0.00 0.83 0.30 -2.74
Theophylline 130 Theophylline 300 0.43 0.84 0.15 -2.73
Colecalciferol 12449 Vitamin D 13423 0.93 0.97 0.01 -2.67
Colecalciferol 3,000unit tablets : 3
Colecalciferol 800unit capsules : 424
Colecalciferol 1,000unit tablets : 127
Colecalciferol 1,000unit capsules : 105
Colecalciferol 400unit capsules : 8
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 60
Colecalciferol 2,000units/ml oral drops sugar free : 2
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 12
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 458
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 12
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 407
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 72
Colecalciferol 400unit / Calcium carbonate 1.25g tablets : 4
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 234
Colecalciferol 5,000unit tablets : 1
Colecalciferol 10,000unit tablets : 3
Colecalciferol 20,000unit tablets : 13
Colecalciferol 800unit tablets : 3
Colecalciferol 40,000unit capsules : 2
Colecalciferol 50,000unit tablets : 1
Colecalciferol 3,200unit capsules : 4
Colecalciferol 25,000units/1ml soln ud amp sugar free : 22
Colecalciferol 25,000unit tablets : 4
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 15
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 2,400units/ml oral drops sugar free : 8
Colecalciferol 20,000unit capsules : 186
Colecalciferol 15,000units/5ml oral solution : 1
Colecalciferol 2,740units/ml oral drops sugar free : 1
Colecalciferol 2,500unit capsules : 2
Colecalciferol 25,000unit capsules : 2
Colecalciferol 400unit tablets : 23
Colecalciferol 50,000unit capsules : 1
Colecalciferol 400units/ml oral drops sugar free : 1
Pro D3 400unit capsules : 9
Pro D3 1,000unit capsules : 27
Pro D3 2,500unit capsules : 9
Pro D3 20,000unit capsules : 2
Pro D3 2,000units/ml liquid drops : 1
Pro D3 2,000units/ml liquid : 2
Accrete D3 tablets : 1931
Accrete D3 One a Day 1000mg/880unit chewable tablets : 376
Valupak Vitamin D3 1,000unit tablets : 47
Adcal-D3 chewable tablets tutti frutti : 350
Adcal-D3 Lemon chewable tablets : 71
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 159
Adcal-D3 750mg/200unit caplets : 1418
Cacit D3 effervescent granules sachets : 4
Calceos 500mg/400unit chewable tablets : 993
Calcichew D3 chewable tablets : 51
Calcichew D3 Forte chewable tablets : 252
Calcichew D3 500mg/400unit caplets : 7
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 18
SunVit-D3 1,000unit tablets : 66
SunVit-D3 10,000unit tablets : 6
SunVit-D3 20,000unit tablets : 79
SunVit-D3 50,000unit tablets : 1
SunVit-D3 2,000unit tablets : 6
SunVit-D3 2,000units/ml oral solution : 1
SunVit-D3 800unit tablets : 12
Fultium-D3 800unit capsules : 854
Fultium-D3 3,200unit capsules : 12
Fultium-D3 20,000unit capsules : 258
Fultium-D3 2,740units/ml oral drops : 2
Pro D3 forte 3,000units/ml liquid : 6
Hux D3 20,000unit capsules : 596
Hux D3 3,200unit capsules : 20
Desunin 800unit tablets : 31
Plenachol D3 20,000unit capsules : 55
Plenachol D3 40,000unit capsules : 1
Evacal D3 1500mg/400unit chewable tablets : 78
Vitamin D3 High Strength 5,000unit tablets : 1
InVita D3 25,000units/1ml oral solution : 314
InVita D3 2,400units/ml oral drops : 80
InVita D3 50,000units/1ml oral solution : 16
InVita D3 800unit capsules : 80
InVita D3 400unit capsules : 3
InVita D3 50,000unit capsules : 1
InVita D3 25,000unit capsules : 8
InVita D3 5,600unit capsules : 2
TheiCal-D3 1000mg/880unit chewable tablets : 1
Stexerol-D3 1,000unit tablets : 276
Stexerol-D3 25,000unit tablets : 884
Thorens 25,000units/2.5ml oral solution : 4
Calci-D 1000mg/1,000unit chewable tablets : 746
Alcohol 0 Alcohols and saline 2 0.00 0.86 0.34 -2.54
Fluconazole 105 Triazole antifungals 152 0.69 0.85 0.07 -2.33