Static outliers for Swb Together4Healthcare 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 Swb Together4Healthcare PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Enzalutamide 2 Prostate cancer and gonadorelin analogues 169 0.01 0.00 0.00 12.92
Irbesartan with diuretic 244 Angiotensin-II receptor antagonists 6747 0.04 0.00 0.00 8.13
Compound alginates and proprietary indigestion preparations 15 Compound Alginates and proprietary indigestion preparations 991 0.02 0.00 0.00 6.00
Testosterone enantate 14 Male sex hormones and antagonists 788 0.02 0.00 0.00 5.67
Insulin glulisine 221 Short-acting insulins 858 0.26 0.03 0.04 5.57

Prescribing where Swb Together4Healthcare PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 5005 Vitamin D 5443 0.92 0.97 0.01 -3.23
Colecalciferol 800unit capsules : 228
Colecalciferol 1,000unit tablets : 3
Colecalciferol 1,000unit capsules : 21
Colecalciferol 400unit capsules : 13
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 : 12
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 45
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 289
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 40
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 110
Colecalciferol 10,000unit tablets : 2
Colecalciferol 800unit tablets : 43
Colecalciferol 40,000unit capsules : 1
Colecalciferol 50,000unit tablets : 3
Colecalciferol 3,200unit capsules : 14
Colecalciferol 25,000units/1ml soln ud amp sugar free : 5
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 7
Colecalciferol 25,000unit tablets : 3
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 13
Colecalciferol 10,000units/ml oral drops sugar free : 4
Colecalciferol 20,000unit capsules : 16
Colecalciferol 2,740units/ml oral drops sugar free : 2
Colecalciferol 50,000units/1ml soln ud amp sugar free : 7
Colecalciferol 2,500unit capsules : 2
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 25
Colecalciferol 25,000unit capsules : 3
Colecalciferol 400unit tablets : 23
Colecalciferol 50,000unit capsules : 36
Colecalciferol 400unit chewable tablets : 5
Colecalciferol 400units/ml oral drops sugar free : 2
Pro D3 400unit capsules : 6
Pro D3 2,500unit capsules : 8
Pro D3 2,000units/ml liquid : 2
Accrete D3 tablets : 188
Adcal-D3 chewable tablets tutti frutti : 764
Adcal-D3 Lemon chewable tablets : 188
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 57
Adcal-D3 750mg/200unit caplets : 952
Cacit D3 effervescent granules sachets : 5
Calceos 500mg/400unit chewable tablets : 28
Calcichew D3 chewable tablets : 33
Calcichew D3 Forte chewable tablets : 45
Calcichew D3 500mg/400unit caplets : 5
Natecal D3 600mg/400unit chewable tablets : 3
SunVit-D3 10,000unit tablets : 1
SunVit-D3 50,000unit tablets : 1
SunVit-D3 3,000unit tablets : 1
SunVit-D3 2,000units/ml oral drops : 2
Fultium-D3 800unit capsules : 86
Fultium-D3 3,200unit capsules : 34
Fultium-D3 20,000unit capsules : 25
Hux D3 20,000unit capsules : 30
Aciferol D3 400unit tablets : 1
Desunin 800unit tablets : 24
OsteoCaps D3 1,000unit capsules : 72
Evacal D3 1500mg/400unit chewable tablets : 15
InVita D3 25,000units/1ml oral solution : 29
InVita D3 50,000units/1ml oral solution : 15
InVita D3 800unit capsules : 33
InVita D3 50,000unit capsules : 272
InVita D3 25,000unit capsules : 28
TheiCal-D3 1000mg/880unit chewable tablets : 13
Stexerol-D3 1,000unit tablets : 1
Thorens 10,000units/ml oral drops : 8
Vitamin D3 400units/ml for infants and children dps : 3
Calci-D 1000mg/1,000unit chewable tablets : 1037
Strivit-D3 800unit capsules : 1
ColeDose D3 25,000unit capsules : 1
Terbinafine hydrochloride 75 Other antifungals 79 0.95 0.99 0.02 -2.49
Alfentanil hydrochloride 0 Opioid analgesics 8 0.00 0.85 0.34 -2.49
Calcium carbonate 97 Calcium supplements 115 0.84 0.96 0.05 -2.35
Clotrimazole 56 Antifungal preparations 291 0.19 0.43 0.11 -2.15