Static outliers for Measham Medical Unit

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 Measham Medical Unit is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Meningococcal B vaccine 41 Vaccines and antisera 183 0.22 0.00 0.01 25.95
Pilocarpine nitrate 42 Treatment of glaucoma 2166 0.02 0.00 0.00 6.63
Quinapril hydrochloride 29 Angiotensin-converting enzyme inhibitors 6615 0.00 0.00 0.00 6.48
Desloratadine 99 Antihistamines 1038 0.10 0.02 0.02 4.41
Edoxaban 1284 Oral anticoagulants 2345 0.55 0.09 0.10 4.40

Prescribing where Measham Medical Unit is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Alcohol 0 Alcohols and saline 2 0.00 0.87 0.33 -2.61
Zinc oxide 1 Soothing haemorrhoidal preparations 7 0.14 0.77 0.27 -2.36
Codeine phosphate 0 Cough suppressants 1 0.00 0.76 0.35 -2.18
Other emollient preparations 234 Emollients 311 0.75 0.89 0.07 -1.95
Colecalciferol 1494 Vitamin D 1630 0.92 0.96 0.02 -1.88
Colecalciferol 800unit capsules : 50
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 42
Adcal-D3 chewable tablets tutti frutti : 52
Adcal-D3 750mg/200unit caplets : 90
Calcichew D3 Forte chewable tablets : 32
Fultium-D3 800unit capsules : 52
TheiCal-D3 1000mg/880unit chewable tablets : 1018
Colecalciferol 3,000unit tablets : 2
Colecalciferol 2,000units/ml oral drops sugar free : 2
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 2
Colecalciferol 25,000unit tablets : 2
Colecalciferol 50,000unit capsules : 2
Accrete D3 tablets : 2
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 1
Colecalciferol 4,000unit tablets : 1
Hux D3 20,000unit capsules : 1
ColeDose D3 20,000unit tablets : 1
Evacal D3 1500mg/400unit chewable tablets : 4
Colecalciferol 20,000unit capsules : 13
Colecalciferol 10,000unit tablets : 3
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 17
Colecalciferol 20,000unit tablets : 12
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 21
Adcal-D3 Lemon chewable tablets : 21
Accrete D3 One a Day 1000mg/880unit chewable tablets : 6
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 15
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 10
Colecalciferol 1,000unit tablets : 5
Colecalciferol 10,000units/ml oral drops sugar free : 5
Fultium-D3 3,200unit capsules : 5
Fultium-D3 20,000unit capsules : 5