Static outliers for Northolt 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 Northolt PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Gentamicin sulfate 1 Antibacterial preparations also used systemically 273 0.00 0.00 0.00 7.79
Aluminium and magnesium and oxetacaine 9 Antacids and simeticone 14 0.64 0.03 0.10 6.22
Propantheline bromide 50 Antispasmodic and other drugs altering gut motility 625 0.08 0.01 0.01 6.16
Flupentixol hydrochloride 81 Antipsychotic drugs 3093 0.03 0.00 0.00 6.09
Patiromer calcium 4 Oral potassium 25 0.16 0.01 0.03 5.47

Prescribing where Northolt PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Flecainide acetate 2 Drugs for arrhythmias 278 0.01 0.46 0.15 -2.99
Colecalciferol 5335 Vitamin D 5779 0.92 0.97 0.01 -2.98
Colecalciferol 800unit capsules : 236
Colecalciferol 1,000unit tablets : 97
Colecalciferol 1,000unit capsules : 9
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 129
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 66
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 19
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 1
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 321
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 7
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 94
Colecalciferol 10,000unit tablets : 4
Colecalciferol 20,000unit tablets : 3
Colecalciferol 800unit tablets : 24
Colecalciferol 40,000unit capsules : 80
Colecalciferol 3,200unit capsules : 1
Colecalciferol 25,000units/1ml soln ud amp sugar free : 1
Colecalciferol 25,000unit tablets : 2
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 23
Colecalciferol 10,000units/ml oral drops sugar free : 6
Colecalciferol 10,000units/ml oral solution sugar free : 3
Colecalciferol 2,400units/ml oral drops sugar free : 7
Colecalciferol 20,000unit capsules : 171
Colecalciferol 50,000units/1ml soln ud amp sugar free : 3
Colecalciferol 4,000unit tablets : 1
Colecalciferol 5,600unit capsules : 1
Colecalciferol 25,000unit capsules : 1
Colecalciferol 400unit tablets : 1
Colecalciferol 400unit chewable tablets : 9
Colecalciferol 2,000unit chewable tablets : 1
Solgar Vitamin D3 1,000unit capsules : 22
Pro D3 1,000unit capsules : 11
Pro D3 20,000unit capsules : 7
Pro D3 2,000units/ml liquid : 5
Pro D3 800unit capsules : 1
Accrete D3 tablets : 664
Accrete D3 One a Day 1000mg/880unit chewable tablets : 3
Valupak Vitamin D3 1,000unit tablets : 2
Adcal-D3 chewable tablets tutti frutti : 334
Adcal-D3 Lemon chewable tablets : 33
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 30
Adcal-D3 750mg/200unit caplets : 696
Calceos 500mg/400unit chewable tablets : 324
Calcichew D3 chewable tablets : 58
Calcichew D3 Forte chewable tablets : 90
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 18
Calfovit D3 oral powder sachets : 3
SunVit-D3 1,000unit tablets : 1
SunVit-D3 20,000unit tablets : 1
SunVit-D3 3,000unit tablets : 1
SunVit-D3 2,000units/ml oral drops : 1
SunVit-D3 400unit tablets : 1
SunVit-D3 800unit tablets : 1
Fultium-D3 800unit capsules : 519
Fultium-D3 3,200unit capsules : 14
Fultium-D3 20,000unit capsules : 287
Fultium-D3 2,740units/ml oral drops : 1
Pro D3 forte 3,000units/ml liquid : 5
Hux D3 20,000unit capsules : 28
Hux D3 3,200unit capsules : 3
Aciferol D3 400unit tablets : 1
Desunin 800unit tablets : 62
Plenachol D3 20,000unit capsules : 7
Plenachol D3 40,000unit capsules : 7
Evacal D3 1500mg/400unit chewable tablets : 8
InVita D3 25,000units/1ml oral solution : 187
InVita D3 2,400units/ml oral drops : 48
InVita D3 50,000units/1ml oral solution : 7
InVita D3 800unit capsules : 1
InVita D3 400unit capsules : 2
InVita D3 50,000unit capsules : 265
InVita D3 25,000unit capsules : 74
TheiCal-D3 1000mg/880unit chewable tablets : 2
Stexerol-D3 1,000unit tablets : 147
Stexerol-D3 25,000unit tablets : 26
Thorens 10,000units/ml oral drops : 6
Water for injection 3 Electrolytes and water 8 0.38 0.81 0.17 -2.60
Furosemide 2139 Loop diuretics 3182 0.67 0.85 0.07 -2.57
Tacrolimus 49 Drugs affecting the immune response 92 0.53 0.80 0.11 -2.40