Static outliers for North Road Suite,Ravensthorpe Health Ctr

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 North Road Suite,Ravensthorpe Health Ctr is higher than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Alverine citrate/simeticone☰	2	Antispasmodic and other drugs altering gut motility	344	0.01	0.00	0.00	7.89
SimAlvia 60mg/300mg capsules : 2
Ferrous gluconate☰	296	Oral iron	687	0.43	0.03	0.05	7.35
Ferrous gluconate 300mg tablets : 296
Ampicillin☰	3	Broad-spectrum penicillins	481	0.01	0.00	0.00	7.24
Ampicillin 250mg capsules : 3
Paraldehyde☰	4	Drugs used in status epilepticus	7	0.57	0.01	0.08	7.15
Paraldehyde 50% in Olive oil rectal solution : 4
Chlorpromazine hydrochloride☰	314	Antipsychotic drugs	1375	0.23	0.02	0.03	7.07
Chlorpromazine 25mg tablets : 149 Chlorpromazine 100mg tablets : 164 Chlorpromazine 50mg tablets : 1

Prescribing where North Road Suite,Ravensthorpe Health Ctr is lower than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Latanoprost☰	39	Treatment of glaucoma	474	0.08	0.31	0.08	-2.70
Latanoprost 50micrograms/ml eye drops : 32 Latanoprost 50micrograms/ml eye dps 0.2ml ud preserv free : 7
Carbocisteine☰	145	Mucolytics	186	0.78	0.97	0.08	-2.39
Carbocisteine 375mg capsules : 140 Carbocisteine 750mg/5ml oral solution sugar free : 1 Mucodyne 375mg capsules : 4
Tiotropium bromide☰	76	Antimuscarinic bronchodilators	241	0.32	0.71	0.18	-2.16
Spiriva Respimat 2.5microg/dose inhalation soln : 40 Braltus 10microgram inhalation pdr caps with Zonda inhaler : 33 Tiotropium bromide 18microgram inhalation powder capsules : 3
Naproxen☰	595	Non-steroidal anti-inflammatory drugs	1220	0.49	0.69	0.10	-1.98
Naproxen 250mg tablets : 114 Naproxen 500mg tablets : 456 Naproxen 375mg gastro-resistant tablets : 2 Naproxen 500mg gastro-resistant tablets : 13 Naproxen 250mg gastro-resistant tablets : 10
Gliclazide☰	541	Sulfonylureas	817	0.66	0.92	0.14	-1.94
Gliclazide 80mg tablets : 293 Gliclazide 40mg tablets : 218 Gliclazide 30mg modified-release tablets : 25 Gliclazide 160mg tablets : 5