Static outliers for Allerton Medical Centre

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 Allerton Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Insulin human 2 Short-acting insulins 130 0.02 0.00 0.00 46.82
Calcium lactate 2 Calcium supplements 33 0.06 0.00 0.00 34.27
Lodoxamide trometamol 28 Other anti-inflammatory preparations 100 0.28 0.01 0.04 7.28
Chloramphenicol 2 Otitis externa 79 0.03 0.00 0.00 6.55
Amiloride hydrochloride with loop diuretics 7 Potassium sparing diuretics and compounds 15 0.47 0.02 0.08 5.47

Prescribing where Allerton Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Cefalexin 23 Cephalosporins 32 0.72 0.96 0.10 -2.35
Famotidine 13 H2-Receptor antagonists 53 0.25 0.78 0.23 -2.29
Tamsulosin hydrochloride 302 Drugs for urinary retention 373 0.81 0.92 0.06 -1.78
Acamprosate calcium 2 Alcohol dependence 6 0.33 0.83 0.31 -1.62
Colecalciferol 1563 Vitamin D 1692 0.92 0.96 0.02 -1.59
Colecalciferol 800unit capsules : 116
Colecalciferol 1,000unit tablets : 93
Colecalciferol 1,000unit capsules : 34
Colecalciferol 400unit capsules : 29
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 291
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 101
Colecalciferol 20,000unit capsules : 52
Adcal-D3 chewable tablets tutti frutti : 122
Adcal-D3 750mg/200unit caplets : 37
Calceos 500mg/400unit chewable tablets : 236
Calcichew D3 Forte chewable tablets : 95
Calfovit D3 oral powder sachets : 54
Calci-D 1000mg/1,000unit chewable tablets : 112
Colecalciferol 2,000unit tablets : 2
Colecalciferol 50,000unit capsules : 2
Accrete D3 One a Day 1000mg/880unit chewable tablets : 2
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 2
Fultium-D3 20,000unit capsules : 2
Hux D3 20,000unit capsules : 2
Aciferol D3 1,000unit tablets : 2
Colecalciferol 3,000unit tablets : 1
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 1
Colecalciferol 25,000units/1ml soln ud amp sugar free : 1
Colecalciferol 25,000unit tablets : 1
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 50,000units/1ml soln ud amp sugar free : 1
Colecalciferol 400units/ml oral drops sugar free : 1
SunVit-D3 10,000unit tablets : 1
SunVit-D3 800unit tablets : 1
Pro D3 forte 3,000units/ml liquid : 1
InVita D3 50,000units/1ml oral solution : 1
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 14
Accrete D3 tablets : 4
InVita D3 25,000units/1ml oral solution : 4
Adcal-D3 Lemon chewable tablets : 18
Desunin 800unit tablets : 27
Cacit D3 effervescent granules sachets : 3
Calcichew D3 chewable tablets : 3
Stexerol-D3 1,000unit tablets : 3
Colecalciferol 400unit / Calcium carbonate 1.25g tablets : 11
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 6
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 6
Valupak Vitamin D3 1,000unit tablets : 6
Strivit-D3 800unit capsules : 6
Colecalciferol 400unit tablets : 15
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 15
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 5
Colecalciferol 800unit tablets : 5
Pro D3 1,000unit capsules : 5
Pro D3 2,000units/ml liquid : 5
SunVit-D3 1,000unit tablets : 5