Static outliers for Crosby & Maghull Partnership 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 Crosby & Maghull Partnership PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Indacaterol/mometasone 1 Corticosteroids (respiratory) 22650 0.00 0.00 0.00 4.10
Irbesartan 5496 Angiotensin-II receptor antagonists 17853 0.31 0.08 0.06 3.94
Clomifene citrate 2 Hypothalamic & anterior pituitary hormone & antioestrogens 2 1.00 0.10 0.24 3.79
Perindopril erbumine 16804 Angiotensin-converting enzyme inhibitors 45947 0.37 0.09 0.08 3.52
Estradiol valandestradiol valerate with dienogest 24 Combined hormonal contraceptives 2238 0.01 0.00 0.00 3.26

Prescribing where Crosby & Maghull Partnership PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Somatropin 0 Hypothalamic & anterior pituitary hormone & antioestrogens 2 0.00 0.89 0.25 -3.49
Tacrolimus 0 Corticosteroids and other immunosuppressants 26 0.00 0.61 0.28 -2.13
Beclometasone dipropionate 382 Drugs used in nasal allergy 7947 0.05 0.24 0.09 -2.12
Mercaptopurine 9 Antimetabolites 34 0.26 0.81 0.27 -2.00
Macrogol 3350 5138 Osmotic laxatives 8830 0.58 0.72 0.07 -1.92
Macrogol compound oral powder sachets NPF sugar free : 1859
Macrogol compound half-strength oral pdr sach NPF sugar free : 10
Macrogol compound oral liquid NPF sugar free : 3
Macrogol 3350 oral powder 8.5g sachets sugar free : 3
Movicol oral powder 13.8g sachets lemon & lime : 199
Movicol-Half oral powder 6.9g sachets : 7
Movicol Plain oral powder 13.7g sachets : 48
Movicol Chocolate oral powder 13.9g sachets : 5
Movicol Paediatric Plain oral powder 6.9g sachets : 529
Movicol Paediatric Chocolate oral powder 6.9g sachets : 23
Laxido Orange oral powder sachets sugar free : 2317
Laxido Paediatric Plain oral powder 6.9g sachets : 62
CosmoCol Orange Lemon and Lime oral powder sachets : 34
CosmoCol Orange Flavour oral powder sachets : 14
CosmoCol Lemon and Lime Flavour oral powder sachets : 13
CosmoCol Paediatric oral powder 6.9g sachets : 7
CosmoCol Plain oral powder sachets : 5