Static outliers for Benfield Park Medical Group

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 Benfield Park Medical Group is higher than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Clemastine fumarate☰	24	Antihistamines	1299	0.02	0.00	0.00	37.21
Clemastine 1mg tablets : 24
Bethanechol chloride☰	6	Drugs for urinary retention	583	0.01	0.00	0.00	16.90
Bethanechol chloride 25mg tablets : 6
Mycophenolic sodium☰	20	Antiproliferative immunosuppressants	64	0.31	0.01	0.03	11.85
Mycophenolic acid 180mg gastro-resistant tablets : 20
Balsalazide sodium☰	43	Aminosalicylates	198	0.22	0.02	0.03	5.94
Balsalazide 750mg capsules : 43
Escitalopram☰	749	Selective serotonin re-uptake inhibitors	4112	0.18	0.04	0.04	4.09
Escitalopram 10mg tablets : 277 Escitalopram 20mg tablets : 293 Escitalopram 5mg tablets : 179

Prescribing where Benfield Park Medical Group is lower than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Alendronic acid☰	244	Bisphosphonates and other drugs	399	0.61	0.87	0.09	-2.82
Alendronic acid 70mg tablets : 231 Alendronic acid 70mg effervescent tablets sugar free : 13
Nitrofurantoin☰	236	Urinary-tract infections	294	0.80	0.97	0.06	-2.69
Nitrofurantoin 100mg modified-release capsules : 228 Nitrofurantoin 100mg tablets : 2 Nitrofurantoin 100mg capsules : 1 Nitrofurantoin 50mg tablets : 5
Ivermectin☰	1	Topical preparation for rosacea	4	0.25	0.88	0.24	-2.66
Soolantra 10mg/g cream : 1
Trimethoprim☰	91	Sulfonamides and trimethoprim	170	0.54	0.86	0.13	-2.55
Trimethoprim 200mg tablets : 41 Trimethoprim 50mg/5ml oral suspension sugar free : 23 Trimethoprim 100mg tablets : 27
Aspirin☰	1615	Antiplatelet drugs	3227	0.50	0.65	0.06	-2.51
Aspirin 75mg dispersible tablets : 1316 Aspirin 75mg tablets : 185 Aspirin 75mg gastro-resistant tablets : 114