Static outliers for Central & West Warrington 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 Central & West Warrington PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Xipamide 25 Thiazides and related diuretics 4445 0.01 0.00 0.00 6.69
Moxisylyte hydorchloride 2 Peripheral vasodilators and related drugs 19 0.11 0.00 0.02 6.38
Naphazoline hydrochloride 5 Other anti-inflammatory preparations 329 0.02 0.00 0.00 6.16
Bromfenac 2 Ocular diagnostic & peri-operative prepn & photodynamic tt 2 1.00 0.09 0.16 5.77
Buspirone hydrochloride 672 Anxiolytics 2753 0.24 0.03 0.04 5.13

Prescribing where Central & West Warrington PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Glucose blood testing reagents 2584 Diabetic diagnostic and monitoring agents 3014 0.86 0.94 0.02 -3.83
OneTouch Verio testing strips : 21
OneTouch Select Plus testing strips : 3
FreeStyle Optium testing strips : 278
GlucoMen areo Sensor testing strips : 348
Active testing strips : 3
FreeStyle testing strips : 9
FreeStyle Lite testing strips : 22
Aviva testing strips : 218
WaveSense JAZZ testing strips : 63
Contour testing strips : 216
CareSens N testing strips : 1
Mobile cassette : 213
GlucoRx Nexus testing strips : 16
GlucoRx HCT Glucose testing strips : 4
Omnitest 3 testing strips : 8
BGStar testing strips : 2
Contour Next testing strips : 123
SD CodeFree testing strips : 31
TRUEyou testing strips : 4
TEE2 testing strips : 18
Dario testing strips : 1
Contour TS testing strips : 30
GluNEO testing strips : 8
Performa testing strips : 526
GlucoZen.auto testing strips : 6
Finetest Lite testing strips : 2
True Metrix testing strips : 3
4SURE testing strips : 363
Contour Plus testing strips : 42
Guide testing strips : 2
Diazepam 1403 Anxiolytics 2753 0.51 0.76 0.08 -3.21
Tamsulosin hydrochloride 2460 Drugs for urinary retention 3029 0.81 0.92 0.04 -2.76
Donepezil hydrochloride 349 Drugs for dementia 1387 0.25 0.49 0.11 -2.09
Bisoprolol fumarate 8729 Beta-adrenoceptor blocking drugs 16182 0.54 0.65 0.06 -2.04