Static outliers for South Somerset East - Rpn 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 South Somerset East - Rpn PCN is higher than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Alirocumab☰	4	Lipid-regulating drugs	19077	0.00	0.00	0.00	23.55
Alirocumab 75mg/1ml inj pre-filled disposable devices : 3 Alirocumab 150mg/1ml inj pre-filled disposable devices : 1
Glycopyrronium/formoterol☰	12	Compound bronchodilator preparations	510	0.02	0.00	0.00	6.40
Glycopyrronium 7.2microg/Formoterol 5microg/dose inh CFCfree : 1 Bevespi Aerosphere 7.2microg / 5microg/dose pressurised inh : 11
Terazosin hydrochloride☰	93	Alpha-adrenoceptor blocking drugs	1810	0.05	0.01	0.01	5.85
Terazosin 2mg tablets : 30 Terazosin 5mg tablets : 22 Terazosin 10mg tablets : 41
Ospemifene☰	7	Preparations for vaginal/vulval changes	759	0.01	0.00	0.00	5.35
Ospemifene 60mg tablets : 7
Fondaparinux sodium☰	6	Parenteral anticoagulants	56	0.11	0.01	0.02	5.01
Fondaparinux sodium 2.5mg/0.5ml inj pre-filled syringes : 1 Fondaparinux sodium 5mg/0.4ml inj pre-filled syringes : 1 Fondaparinux sodium 7.5mg/0.6ml inj pre-filled syringes : 4

Prescribing where South Somerset East - Rpn PCN is lower than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Doxazosin mesilate☰	1717	Alpha-adrenoceptor blocking drugs	1810	0.95	0.99	0.01	-3.87
Doxazosin 1mg tablets : 211 Doxazosin 2mg tablets : 535 Doxazosin 4mg tablets : 698 Doxazosin 4mg modified-release tablets : 114 Doxazosin 8mg modified-release tablets : 78 Doxazosin 8mg tablets : 21 Doxadura 4mg tablets : 33 Doxadura XL 4mg tablets : 27
Somatropin☰	0	Hypothalamic & anterior pituitary hormone & antioestrogens	10	0.00	0.89	0.25	-3.49
Sertraline hydrochloride☰	3010	Selective serotonin re-uptake inhibitors	9675	0.31	0.46	0.06	-2.55
Sertraline 50mg tablets : 1714 Sertraline 100mg tablets : 1283 Sertraline 50mg/5ml oral suspension : 5 Sertraline 25mg tablets : 8
Naftidrofuryl oxalate☰	0	Peripheral vasodilators and related drugs	3	0.00	0.67	0.28	-2.38
Vitamin E☰	0	Vitamin E	1	0.00	0.73	0.33	-2.24