Static outliers for Blackpool Central 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 Blackpool Central PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Triamcinolone hexacetonide 119 Local corticosteroid injections 347 0.34 0.0 0.02 14.42
Alclometasone dipropionate 6 Topical corticosteroids 4009 0.00 0.0 0.00 14.29
Amphotericin 1 Oropharyngeal anti-infective drugs 64 0.02 0.0 0.00 9.29
Nadolol 101 Beta-adrenoceptor blocking drugs 24119 0.00 0.0 0.00 6.87
Lormetazepam 51 Hypnotics 2885 0.02 0.0 0.00 5.23

Prescribing where Blackpool Central PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Miconazole 63 Oropharyngeal anti-infective drugs 64 0.98 1.00 0.00 -7.23
Mesalazine (Systemic) 468 Aminosalicylates 1121 0.42 0.64 0.10 -2.30
Mesalazine 400mg gastro-resistant tablets : 36
Mesalazine 500mg suppositories : 6
Mesalazine 500mg modified-release tablets : 11
Mesalazine 1g suppositories : 8
Mesalazine 1g/application foam enema : 10
Mesalazine 2g/59ml enema : 1
Mesalazine 800mg gastro-resistant tablets : 39
Mesalazine 2g modified-release granules sachets sugar free : 3
Mesalazine 1.5g gast res MR gran sachets sugar free : 1
Mesalazine 500mg gastro-resistant tablets : 5
Mesalazine 1g gast res MR gran sachets sugar free : 11
Mesalazine 1g modified-release tablets : 9
Asacol 400mg MR gastro-resistant tablets : 34
Asacol 800mg MR gastro-resistant tablets : 164
Pentasa 500mg modified-release tablets : 10
Pentasa 1g suppositories : 13
Pentasa 1g modified-release granules sachets : 4
Pentasa 2g modified-release granules sachets : 10
Pentasa 1g modified-release tablets : 25
Salofalk 500mg suppositories : 7
Salofalk 1g/application foam enema : 6
Salofalk 500mg gast res MR gran sachets : 6
Salofalk 1.5g gastro-resistant modified-release gran sachets : 3
Salofalk 500mg gastro-resistant tablets : 5
Mezavant XL 1200mg tablets : 12
Octasa 800mg MR gastro-resistant tablets : 24
Octasa 400mg MR gastro-resistant tablets : 5
Ferrous fumarate 457 Oral iron 3485 0.13 0.57 0.20 -2.23
Sumatriptan succinate 662 Treatment of acute migraine 1285 0.52 0.66 0.07 -2.16
Vitamin B compound 576 Vitamin B compound 580 0.99 1.00 0.00 -2.13