Static outliers for Cheetham Hill & Crumpsall 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 Cheetham Hill & Crumpsall PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Enzalutamide 6 Prostate cancer and gonadorelin analogues 213 0.03 0.0 0.00 30.88
Quinapril hydrochloride with diuretic 10 Angiotensin-converting enzyme inhibitors 14072 0.00 0.0 0.00 14.00
Dicycloverine hydrochloride compound preparations 127 Antispasmodic and other drugs altering gut motility 2159 0.06 0.0 0.01 7.00
Penicillamine 26 Rheumatic disease suppressant drugs 791 0.03 0.0 0.00 6.30
Canagliflozin/metformin 142 Other antidiabetic drugs 10841 0.01 0.0 0.00 5.85

Prescribing where Cheetham Hill & Crumpsall PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ursodeoxycholic acid 88 Drugs affecting biliary composition and flow 93 0.95 1.00 0.00 -43.03
Isosorbide mononitrate 1271 Nitrates 2293 0.55 0.73 0.07 -2.65
Fluconazole 180 Triazole antifungals 261 0.69 0.85 0.07 -2.34
Neomycin sulfate 170 Nasal preparations for infection 250 0.68 0.84 0.07 -2.30
Colecalciferol 7365 Vitamin D 7892 0.93 0.97 0.01 -2.26
Colecalciferol 3,000unit tablets : 6
Colecalciferol 800unit capsules : 307
Colecalciferol 15,000units/5ml oral suspension : 2
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit tablets : 64
Colecalciferol 1,000unit capsules : 194
Colecalciferol 400unit capsules : 96
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 14
Colecalciferol 2,000units/ml oral drops sugar free : 19
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 6
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 224
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 432
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 2
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 73
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 108
Colecalciferol 5,000unit tablets : 1
Colecalciferol 10,000unit tablets : 1
Colecalciferol 20,000unit tablets : 5
Colecalciferol 800unit tablets : 56
Colecalciferol 40,000unit capsules : 2
Colecalciferol 200units/drop oral drops sugar free : 6
Colecalciferol 2,000unit tablets : 13
Colecalciferol 3,200unit capsules : 2
Colecalciferol 25,000units/1ml soln ud amp sugar free : 5
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 4
Colecalciferol 10,000units/ml oral drops sugar free : 11
Colecalciferol 10,000units/ml oral solution sugar free : 18
Colecalciferol 2,400units/ml oral drops sugar free : 1
Colecalciferol 20,000unit capsules : 78
Colecalciferol 2,740units/ml oral drops sugar free : 21
Colecalciferol 10,000unit capsules : 1
Colecalciferol 4,000unit tablets : 5
Colecalciferol 400unit tablets : 84
Colecalciferol 15,000units/5ml oral solution sugar free : 4
Colecalciferol 50,000unit capsules : 1
Colecalciferol 400units/ml oral drops sugar free : 1
Colecalciferol 200units/drop oral drops : 10
Solgar Vitamin D3 1,000unit tablets : 1
BabyD 1,000units/ml oral solution : 1
Pro D3 2,000units/ml liquid drops : 2
Lamberts Vitamin D3 400unit tablets : 1
Accrete D3 tablets : 86
Accrete D3 One a Day 1000mg/880unit chewable tablets : 13
Valupak Vitamin D3 1,000unit tablets : 4
Adcal-D3 chewable tablets tutti frutti : 1829
Adcal-D3 Lemon chewable tablets : 152
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 79
Adcal-D3 750mg/200unit caplets : 1121
Cacit D3 effervescent granules sachets : 15
Calceos 500mg/400unit chewable tablets : 88
Calcichew D3 chewable tablets : 46
Calcichew D3 Forte chewable tablets : 472
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 4
Calfovit D3 oral powder sachets : 24
Natecal D3 600mg/400unit chewable tablets : 6
SunVit-D3 400unit tablets : 5
SunVit-D3 800unit tablets : 7
SunVit-D3 400unit capsules : 1
SunVit-D3 10,000unit capsules : 4
SunVit-D3 3,000units/ml oral solution : 1
SunVit-D3 800unit capsules : 25
SunVit-D3 20,000unit capsules : 1
Fultium-D3 800unit capsules : 287
Fultium-D3 3,200unit capsules : 15
Fultium-D3 20,000unit capsules : 40
Fultium-D3 2,740units/ml oral drops : 1
Hux D3 20,000unit capsules : 814
Aciferol D3 3,000units/ml liquid : 1
OsteoCaps D3 20,000unit capsules : 1
Evacal D3 1500mg/400unit chewable tablets : 230
Vitamin D3 High Strength 5,000unit tablets : 1
InVita D3 25,000units/1ml oral solution : 12
InVita D3 2,400units/ml oral drops : 1
InVita D3 800unit capsules : 12
TheiCal-D3 1000mg/880unit chewable tablets : 3
Stexerol-D3 1,000unit tablets : 6
Thorens 10,000units/ml oral drops : 11
Thorens 25,000units/2.5ml oral solution : 2
Calci-D 1000mg/1,000unit chewable tablets : 18
SunVit-D3 400unit with Calcium 500mg chewable tablets : 44