Static outliers for Redditch & Bromsgrove Kingfisher 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 Redditch & Bromsgrove Kingfisher PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Antazoline 27 Other anti-inflammatory preparations 306 0.09 0.01 0.01 6.38
Mexiletine hydrochloride 7 Drugs for arrhythmias 177 0.04 0.00 0.01 4.50
Acrivastine 62 Antihistamines 3891 0.02 0.00 0.00 4.31
Trimetazidine hydrochloride 5 Calcium-channel blockers 13255 0.00 0.00 0.00 3.72
Glipizide 64 Sulfonylureas 1478 0.04 0.00 0.01 3.53

Prescribing where Redditch & Bromsgrove Kingfisher PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Filgrastim 0 Drugs used in neutropenia 1 0.00 0.85 0.36 -2.35
Colecalciferol 5109 Vitamin D 5478 0.93 0.97 0.01 -2.31
Colecalciferol 800unit capsules : 589
Colecalciferol 1,000unit tablets : 12
Colecalciferol 1,000unit capsules : 16
Colecalciferol 400unit capsules : 10
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 5
Colecalciferol 2,000units/ml oral drops sugar free : 6
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 7
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 38
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 73
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 3
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 8
Colecalciferol 400units/dose oral spray sugar free : 3
Colecalciferol 800unit tablets : 213
Colecalciferol 40,000unit capsules : 3
Colecalciferol 2,000unit tablets : 1
Colecalciferol 3,200unit capsules : 1
Colecalciferol 25,000units/1ml soln ud amp sugar free : 4
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 2,400units/ml oral drops sugar free : 1
Colecalciferol 20,000unit capsules : 86
Colecalciferol 2,500unit capsules : 2
Colecalciferol 5,000unit capsules : 7
Colecalciferol 400unit tablets : 13
Colecalciferol 50,000unit capsules : 1
Pro D3 400unit capsules : 3
Accrete D3 tablets : 5
Adcal-D3 chewable tablets tutti frutti : 1146
Adcal-D3 Lemon chewable tablets : 245
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 111
Adcal-D3 750mg/200unit caplets : 486
Cacit D3 effervescent granules sachets : 5
Calceos 500mg/400unit chewable tablets : 64
Calcichew D3 chewable tablets : 57
Calcichew D3 Forte chewable tablets : 563
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 7
Calfovit D3 oral powder sachets : 21
SunVit-D3 800unit tablets : 5
SunVit-D3 10,000unit capsules : 1
SunVit-D3 1,000unit Vegan tablets : 2
Fultium-D3 800unit capsules : 185
Fultium-D3 3,200unit capsules : 2
Fultium-D3 20,000unit capsules : 5
Fultium-D3 2,740units/ml oral drops : 3
Hux D3 20,000unit capsules : 46
Desunin 800unit tablets : 12
OsteoCaps D3 1,000unit capsules : 52
Evacal D3 1500mg/400unit chewable tablets : 12
InVita D3 25,000units/1ml oral solution : 21
InVita D3 2,400units/ml oral drops : 12
InVita D3 50,000unit capsules : 10
InVita D3 25,000unit capsules : 8
Stexerol-D3 1,000unit tablets : 6
Stexerol-D3 25,000unit tablets : 1
Thorens 10,000units/ml oral drops : 3
Calci-D 1000mg/1,000unit chewable tablets : 907
Estradiol with progestogen 465 Oestrogens and Hormone Replacement Therapy 1928 0.24 0.38 0.07 -2.10
Ganciclovir 0 Antivirals 2 0.00 0.70 0.34 -2.06
Erythromycin 6 Topical preparations for acne 431 0.01 0.12 0.05 -2.02