Static outliers for Torquay 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 Torquay PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sucroferric oxyhydroxide 4 Phosphate binding agents 15 0.27 0.00 0.02 12.91
Squill 1 Expectorant and demulcent cough preparations 12 0.08 0.00 0.01 7.83
Low protein bread 16 Foods for special diets 293 0.05 0.00 0.01 5.89
Glutaraldehyde 4 Preparations for warts and calluses 26 0.15 0.01 0.03 4.96
Indoramin 88 Drugs for urinary retention 3358 0.03 0.00 0.00 4.71

Prescribing where Torquay PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Acamprosate calcium 3 Alcohol dependence 28 0.11 0.83 0.24 -3.06
Mesalazine (Systemic) 333 Aminosalicylates 875 0.38 0.64 0.10 -2.68
Mesalazine 400mg gastro-resistant tablets : 2
Mesalazine 1g/100ml enema : 1
Mesalazine 500mg modified-release tablets : 6
Mesalazine 1g suppositories : 1
Mesalazine 1g/application foam enema : 1
Mesalazine 2g modified-release granules sachets sugar free : 11
Mesalazine 1g modified-release tablets : 11
Asacol 400mg MR gastro-resistant tablets : 56
Asacol 800mg MR gastro-resistant tablets : 11
Pentasa Mesalazine 1g/100ml enema : 1
Pentasa 500mg modified-release tablets : 47
Pentasa 1g suppositories : 25
Pentasa 1g modified-release granules sachets : 10
Pentasa 2g modified-release granules sachets : 29
Pentasa 1g modified-release tablets : 79
Salofalk 500mg suppositories : 2
Salofalk 2g/59ml enema : 1
Salofalk 1g/application foam enema : 5
Salofalk 1g gastro-resistant modified-release gran sachets : 2
Mezavant XL 1200mg tablets : 12
Octasa 800mg MR gastro-resistant tablets : 17
Octasa 400mg MR gastro-resistant tablets : 3
Ferrous fumarate 166 Oral iron 2088 0.08 0.57 0.20 -2.49
Clotrimazole 228 Vaginal and vulval infections 293 0.78 0.90 0.05 -2.33
Glycopyrronium bromide 0 Antimuscarinic drugs 117 0.00 0.78 0.37 -2.11