Static outliers for Bury St Edmonds 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 Bury St Edmonds PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Eprosartan 690 Angiotensin-II receptor antagonists 16415 0.04 0.0 0.00 11.52
Glipizide 231 Sulfonylureas 2491 0.09 0.0 0.01 7.97
Meptazinol hydrochloride 893 Opioid analgesics 11282 0.08 0.0 0.01 7.47
Potassium bicarbonate 1 Oral bicarbonate 86 0.01 0.0 0.00 7.02
Ergocalciferol 270 Vitamin D 12945 0.02 0.0 0.00 5.80

Prescribing where Bury St Edmonds PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sodium bicarbonate 85 Oral bicarbonate 86 0.99 1.00 0.00 -7.02
Nitrofurantoin 1736 Urinary-tract infections 2550 0.68 0.96 0.05 -5.50
Tramadol hydrochloride 1522 Opioid analgesics 11282 0.13 0.26 0.06 -2.20
Colecalciferol 12124 Vitamin D 12945 0.94 0.97 0.01 -2.03
Colecalciferol 3,000unit tablets : 7
Colecalciferol 800unit capsules : 348
Colecalciferol 600unit capsules : 2
Colecalciferol 1,000unit tablets : 764
Colecalciferol 1,000unit capsules : 547
Colecalciferol 400unit capsules : 64
Colecalciferol 5,000units/5ml oral solution : 5
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 23
Colecalciferol 2,000units/ml oral drops sugar free : 4
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 143
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 327
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 24
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 1649
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 89
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 43
Colecalciferol 5,000unit tablets : 18
Colecalciferol 2,200unit tablets : 20
Colecalciferol 10,000unit tablets : 5
Colecalciferol 20,000unit tablets : 12
Colecalciferol 800unit tablets : 241
Colecalciferol 40,000unit capsules : 1
Colecalciferol 50,000unit tablets : 6
Colecalciferol 2,000unit tablets : 150
Colecalciferol 2,000unit orodispersible tablets sugar free : 4
Colecalciferol 25,000units/1ml soln ud amp sugar free : 4
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 5
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 42
Colecalciferol 20,000unit capsules : 30
Colecalciferol 50,000units/1ml soln ud amp sugar free : 34
Colecalciferol 10,000unit capsules : 3
Colecalciferol 2,200unit capsules : 32
Colecalciferol 2,500unit capsules : 3
Colecalciferol 5,000unit capsules : 6
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 21
Colecalciferol 4,000unit tablets : 2
Colecalciferol 400unit tablets : 78
Colecalciferol 400unit chewable tablets : 2
Colecalciferol 400units/ml oral drops sugar free : 9
Colecalciferol 200units/drop oral drops : 1
Solgar Vitamin D3 1,000unit capsules : 2
Pro D3 1,000unit capsules : 4
Pro D3 800unit capsules : 2
Accrete D3 tablets : 327
Accrete D3 One a Day 1000mg/880unit chewable tablets : 24
Valupak Vitamin D3 1,000unit tablets : 1148
Adcal-D3 chewable tablets tutti frutti : 1468
Adcal-D3 Lemon chewable tablets : 124
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 94
Adcal-D3 750mg/200unit caplets : 175
Cacit D3 effervescent granules sachets : 5
Calceos 500mg/400unit chewable tablets : 294
Calcichew D3 chewable tablets : 205
Calcichew D3 Forte chewable tablets : 582
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 22
SunVit-D3 1,000unit tablets : 9
SunVit-D3 20,000unit tablets : 1
SunVit-D3 2,000unit tablets : 48
Fultium-D3 800unit capsules : 157
Fultium-D3 3,200unit capsules : 6
DLux 400 oral spray : 2
Bio-Vitamin D3 800unit capsules : 5
Bio-Vitamin D3 1,000unit capsules : 6
Bio-Vitamin D3 20,000unit capsules : 25
Desunin 800unit tablets : 77
BioLife Vitamin D3 1,000unit tablets : 4
OsteoCaps D3 1,000unit capsules : 7
Evacal D3 1500mg/400unit chewable tablets : 1987
HealthAid Vitamin D3 200units/drop oral drops : 4
InVita D3 25,000units/1ml oral solution : 4
InVita D3 50,000units/1ml oral solution : 18
InVita D3 800unit capsules : 300
InVita D3 400unit capsules : 10
InVita D3 50,000unit capsules : 5
TheiCal-D3 1000mg/880unit chewable tablets : 14
Stexerol-D3 1,000unit tablets : 6
Calci-D 1000mg/1,000unit chewable tablets : 173
Strivit-D3 20,000unit capsules : 1
ColeDose D3 2,000unit tablets : 11
Atropine sulfate 19 Mydriatics and cycloplegics 58 0.33 0.75 0.22 -1.91