Static outliers for Waterside 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 Waterside PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Exenatide 213 Other antidiabetic drugs 3879 0.05 0.01 0.01 9.29
Denosumab 226 Bisphosphonates and other drugs 1542 0.15 0.01 0.02 7.14
Triptorelin embonate 50 Prostate cancer and gonadorelin analogues 182 0.27 0.02 0.04 5.96
Pentazocine hydrochloride 10 Opioid analgesics 6360 0.00 0.00 0.00 5.60
Telmisartan 536 Angiotensin-II receptor antagonists 5671 0.09 0.01 0.01 5.59

Prescribing where Waterside PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Carbimazole 90 Antithyroid drugs 128 0.70 0.93 0.04 -5.13
Furosemide 1850 Loop diuretics 3242 0.57 0.85 0.07 -4.00
Prednisolone 1764 Use of corticosteroids 2329 0.76 0.88 0.03 -3.90
Finasteride 1075 Male sex hormones and antagonists 1652 0.65 0.83 0.07 -2.41
Folic acid 1242 Drugs used in megaloblastic anaemias 3366 0.37 0.68 0.13 -2.37