Static outliers for Newcastle Outer West 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 Newcastle Outer West PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Benzocaine 8 Topical local anaesthetics and antipruritics 93 0.09 0.00 0.00 26.00
Balsalazide sodium 213 Aminosalicylates 1331 0.16 0.02 0.02 6.64
Saxagliptin 448 Other antidiabetic drugs 4441 0.10 0.01 0.02 4.95
Nimodipine 7 Calcium-channel blockers 22766 0.00 0.00 0.00 4.88
Calcium lactate 3 Calcium supplements 293 0.01 0.00 0.00 4.43

Prescribing where Newcastle Outer West PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Alginic acid compound preparations 1867 Compound Alginates and proprietary indigestion preparations 1925 0.97 1.00 0.01 -3.71
Urea hydrogen peroxide 0 Removal of ear wax and other substances 1 0.00 0.83 0.26 -3.22
Alendronic acid 2303 Bisphosphonates and other drugs 3605 0.64 0.87 0.07 -3.11
Mesalazine (Systemic) 451 Aminosalicylates 1331 0.34 0.64 0.10 -3.11
Mesalazine 400mg gastro-resistant tablets : 16
Mesalazine 500mg suppositories : 5
Mesalazine 1g/100ml enema : 2
Mesalazine 1g suppositories : 27
Mesalazine 1g/application foam enema : 1
Mesalazine 2g/59ml enema : 1
Mesalazine 800mg gastro-resistant tablets : 1
Mesalazine 1g modified-release tablets : 2
Asacol 400mg MR gastro-resistant tablets : 31
Asacol 800mg MR gastro-resistant tablets : 21
Pentasa 500mg modified-release tablets : 40
Pentasa 1g suppositories : 5
Pentasa 1g modified-release granules sachets : 17
Pentasa 2g modified-release granules sachets : 20
Pentasa 1g modified-release tablets : 8
Pentasa 4g modified-release granules sachets : 5
Salofalk 1g/application foam enema : 1
Salofalk 1g gastro-resistant modified-release gran sachets : 2
Mezavant XL 1200mg tablets : 21
Octasa 800mg MR gastro-resistant tablets : 41
Octasa 400mg MR gastro-resistant tablets : 184
Co-codamol (Codeine phosphate/paracetamol) 1645 Non-opioid analgesics and compound preparations 22404 0.07 0.44 0.12 -3.00