Static outliers for Poole Central 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 Poole Central PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Urine testing reagents 307 Diabetic diagnostic and monitoring agents 3418 0.09 0.01 0.01 6.31
Levothyroxine sodium and liothyronine 16 Thyroid hormones 10623 0.00 0.00 0.00 6.14
Other HIV infection preparations 4 HIV infection 6 0.67 0.02 0.12 5.32
Nifedipine 1134 Calcium-channel blockers 13419 0.08 0.03 0.01 4.34
Nifedipine 5mg capsules : 24
Nifedipine 10mg capsules : 28
Nifedipine 10mg modified-release tablets : 13
Nifedipine 20mg modified-release capsules : 3
Nifedipine 10mg modified-release capsules : 12
Nifedipine 30mg modified-release tablets : 4
Nifedipine 60mg modified-release tablets : 2
Nifedipine 30mg modified-release capsules : 5
Nifedipine 60mg modified-release capsules : 7
Adalat retard 10mg tablets : 1
Adalat LA 30mg tablets : 12
Adalat LA 60mg tablets : 5
Coracten SR 20mg capsules : 111
Coracten SR 10mg capsules : 111
Coracten XL 30mg capsules : 385
Coracten XL 60mg capsules : 251
Adipine XL 30mg tablets : 55
Adipine XL 60mg tablets : 15
Tensipine MR 10 tablets : 7
Tensipine MR 20 tablets : 4
Fortipine LA 40 tablets : 3
Nifedipress MR 10 tablets (Dexcel-Pharma) : 32
Nifedipress MR 20 tablets (Dexcel-Pharma) : 18
Valni XL 30mg tablets : 3
Adanif XL 30mg tablets : 23
Meloxicam 1240 Non-steroidal anti-inflammatory drugs 6964 0.18 0.04 0.03 4.24

Prescribing where Poole Central PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Glucose blood testing reagents 2983 Diabetic diagnostic and monitoring agents 3418 0.87 0.94 0.02 -3.15
OneTouch Verio testing strips : 27
OneTouch Select Plus testing strips : 62
FreeStyle Optium testing strips : 177
GlucoMen LX Sensor testing strips : 3
GlucoMen areo Sensor testing strips : 15
Active testing strips : 2
FreeStyle testing strips : 6
FreeStyle Lite testing strips : 34
Aviva testing strips : 214
WaveSense JAZZ testing strips : 412
WaveSense JAZZ Duo testing strips : 29
Contour testing strips : 18
Mylife Pura testing strips : 1
Mobile cassette : 213
GlucoRx Q testing strips : 5
GlucoRx Nexus testing strips : 1522
GlucoRx HCT Glucose testing strips : 26
GlucoLab testing strips : 4
Contour Next testing strips : 77
TRUEyou testing strips : 2
Dario testing strips : 1
Contour TS testing strips : 1
GluNEO testing strips : 2
Performa testing strips : 74
Finetest Lite testing strips : 6
CareSens PRO testing strips : 1
True Metrix testing strips : 1
4SURE testing strips : 17
Kinetik Wellbeing testing strips : 1
Guide testing strips : 1
Instant testing strips : 29
Somatropin 1 Hypothalamic & anterior pituitary hormone & antioestrogens 5 0.20 0.89 0.25 -2.71
Alfentanil hydrochloride 0 Opioid analgesics 1 0.00 0.85 0.34 -2.49
Naproxen 3969 Non-steroidal anti-inflammatory drugs 6964 0.57 0.69 0.06 -1.91
Ferrous fumarate 501 Oral iron 2276 0.22 0.57 0.20 -1.78