Static outliers for Gainford Surgery

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 Gainford Surgery is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ketoprofen 27 Non-steroidal anti-inflammatory drugs 476 0.06 0.00 0.00 17.05
Chlordiazepoxide hydrochloride 14 Anxiolytics 61 0.23 0.01 0.02 14.40
Ergocalciferol 48 Vitamin D 527 0.09 0.00 0.01 13.99
Alverine citrate/simeticone 1 Antispasmodic and other drugs altering gut motility 123 0.01 0.00 0.00 11.07
Probenecid 4 Gout and cytotoxic induced hyperiuicaemia 460 0.01 0.00 0.00 10.44

Prescribing where Gainford Surgery is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Tacrolimus 1 Drugs affecting the immune response 19 0.05 0.81 0.21 -3.65
Gliclazide 42 Sulfonylureas 84 0.50 0.92 0.14 -3.13
Amitriptyline hydrochloride 357 Tricyclic and related antidepressant drugs 567 0.63 0.84 0.08 -2.75
Acamprosate calcium 0 Alcohol dependence 2 0.00 0.83 0.31 -2.70
Colecalciferol 474 Vitamin D 527 0.90 0.96 0.02 -2.57
Accrete D3 tablets : 145
Fultium-D3 800unit capsules : 86
Evacal D3 1500mg/400unit chewable tablets : 142
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 2
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 2
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 2
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 2
InVita D3 2,400units/ml oral drops : 2
ColeKal-D3 1,000unit capsules : 1
ColeDose D3 20,000unit capsules : 1
Fultium-D3 20,000unit capsules : 9
Calcichew D3 Forte chewable tablets : 4
Colecalciferol 800unit capsules : 8
Colecalciferol 20,000unit capsules : 8
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 3
Aviticol 1,000unit capsules : 3
Adcal-D3 750mg/200unit caplets : 17
Adcal-D3 chewable tablets tutti frutti : 12
Accrete D3 One a Day 1000mg/880unit chewable tablets : 6
Colecalciferol 1,000unit capsules : 19