Static outliers for Oak Glen 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 Oak Glen Surgery is higher than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Nabilone☰	5	Drugs used in nausea and vertigo	132	0.04	0.00	0.00	72.17
Nabilone 1mg capsules : 5
Ibuprofen lysine☰	4	Non-steroidal anti-inflammatory drugs	206	0.02	0.00	0.00	18.45
Ibuprofen lysine 400mg tablets : 4
Dornase alfa☰	3	Mucolytics	42	0.07	0.00	0.01	6.46
Dornase alfa 2.5mg/2.5ml nebuliser liquid ampoules : 3
Risedronate sodium☰	84	Bisphosphonates and other drugs	138	0.61	0.09	0.08	6.35
Risedronate sodium 35mg tablets : 84
Clemastine fumarate☰	1	Antihistamines	344	0.00	0.00	0.00	5.72
Clemastine 1mg tablets : 1

Prescribing where Oak Glen Surgery is lower than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Alendronic acid☰	46	Bisphosphonates and other drugs	138	0.33	0.87	0.09	-5.83
Alendronic acid 70mg tablets : 41 Alendronic acid 70mg/100ml soln unit dose sugar free : 5
Gliclazide☰	55	Sulfonylureas	114	0.48	0.92	0.14	-3.26
Gliclazide 80mg tablets : 33 Gliclazide 30mg modified-release tablets : 9 Gliclazide 40mg tablets : 13
Cefalexin☰	7	Cephalosporins	10	0.70	0.96	0.10	-2.54
Cefalexin 500mg capsules : 4 Cefalexin 250mg capsules : 3
Omeprazole☰	162	Proton pump inhibitors	1363	0.12	0.50	0.16	-2.34
Omeprazole 20mg gastro-resistant capsules : 126 Omeprazole 20mg gastro-resistant tablets : 3 Omeprazole 10mg gastro-resistant capsules : 17 Omeprazole 40mg gastro-resistant capsules : 16
Mercaptopurine☰	0	Antimetabolites	2	0.00	0.80	0.35	-2.31