Static outliers for Crewe - Ghr 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 Crewe - Ghr PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Calcitriol 203 Vitamin D 5870 0.03 0.00 0.00 13.25
Urine testing reagents 268 Diabetic diagnostic and monitoring agents 2518 0.11 0.01 0.01 7.62
Titanium dioxide 1 Sunscreening preparations 56 0.02 0.00 0.00 4.27
Sulindac 5 Non-steroidal anti-inflammatory drugs 2636 0.00 0.00 0.00 4.27
Pravastatin sodium 1588 Lipid-regulating drugs 21904 0.07 0.03 0.01 3.90

Prescribing where Crewe - Ghr PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Glucose blood testing reagents 2199 Diabetic diagnostic and monitoring agents 2518 0.87 0.94 0.02 -3.13
OneTouch Verio testing strips : 16
OneTouch Select Plus testing strips : 38
FreeStyle Optium testing strips : 38
GlucoMen LX Sensor testing strips : 3
GlucoMen areo Sensor testing strips : 33
Active testing strips : 20
FreeStyle testing strips : 11
FreeStyle Lite testing strips : 24
Aviva testing strips : 89
WaveSense JAZZ testing strips : 67
Contour testing strips : 29
Mobile cassette : 410
GlucoRx Nexus testing strips : 549
GlucoRx HCT Glucose testing strips : 12
GlucoRx GO testing strips : 1
Omnitest 3 testing strips : 3
Omnitest 5 testing strips : 26
Contour Next testing strips : 49
TRUEyou testing strips : 53
TEE2 testing strips : 3
Contour TS testing strips : 3
Performa testing strips : 686
GlucoZen.auto testing strips : 8
Finetest Lite testing strips : 3
palmdoc testing strips : 18
Contour Plus testing strips : 1
Kinetik Wellbeing testing strips : 6
Mercaptopurine 0 Antimetabolites 4 0.00 0.81 0.27 -2.96
Furosemide 2314 Loop diuretics 3376 0.69 0.85 0.07 -2.38
Other food for special diet preparations 88 Foods for special diets 310 0.28 0.64 0.17 -2.05
Ciprofloxacin 64 Quinolones 93 0.69 0.85 0.08 -1.97