Static outliers for Derby Family 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 Derby Family Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Tafluprost and timolol 16 Treatment of glaucoma 227 0.07 0.00 0.01 8.72
Timolol 22 Beta-adrenoceptor blocking drugs 1992 0.01 0.00 0.00 7.63
Triptorelin acetate 10 Prostate cancer and gonadorelin analogues 27 0.37 0.02 0.06 5.89
Loprazolam mesilate 5 Hypnotics 136 0.04 0.00 0.01 5.30
Acenocoumarol 6 Oral anticoagulants 351 0.02 0.00 0.00 5.22

Prescribing where Derby Family Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Calcium carbonate 6 Calcium supplements 17 0.35 0.95 0.13 -4.49
Colecalciferol 648 Vitamin D 748 0.87 0.96 0.02 -3.91
Colecalciferol 800unit capsules : 42
Accrete D3 tablets : 30
Adcal-D3 chewable tablets tutti frutti : 111
Adcal-D3 750mg/200unit caplets : 94
Calcichew D3 Forte chewable tablets : 39
Hux D3 20,000unit capsules : 36
Strivit-D3 20,000unit capsules : 96
Colecalciferol 2,000units/ml oral drops sugar free : 2
InVita D3 25,000units/1ml oral solution : 2
Colecalciferol 10,000unit tablets : 1
Colecalciferol 10,000units/ml oral drops sugar free : 1
Pro D3 2,000units/ml liquid drops : 1
SunVit-D3 1,000unit tablets : 1
Fultium-D3 800unit capsules : 28
Calceos 500mg/400unit chewable tablets : 13
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 8
Calcichew D3 chewable tablets : 3
SunVit-D3 2,000units/ml oral drops : 7
Desunin 800unit tablets : 7
Colecalciferol 1,000unit tablets : 16
Thorens 10,000units/ml oral drops : 11
Colecalciferol 3,200unit capsules : 6
Valupak Vitamin D3 1,000unit tablets : 6
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 6
SunVit-D3 400unit tablets : 6
Pro D3 forte 3,000units/ml liquid : 6
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 20
Adcal-D3 Lemon chewable tablets : 15
Colecalciferol 800unit tablets : 10
Accrete D3 One a Day 1000mg/880unit chewable tablets : 5
Evacal D3 1500mg/400unit chewable tablets : 19
Quetiapine 18 Antipsychotic drugs 481 0.04 0.35 0.12 -2.52
Co-codamol (Codeine phosphate/paracetamol) 183 Non-opioid analgesics and compound preparations 1759 0.10 0.45 0.15 -2.26
Codeine phosphate 0 Cough suppressants 1 0.00 0.76 0.35 -2.18