Static outliers for Beacon Medical Practice

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 Beacon Medical Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Aminosalicylic acid 1 Antituberculosis drugs 1 1.00 0.00 0.04 26.29
Oils for the ear 3 Removal of ear wax and other substances 4 0.75 0.01 0.10 7.14
Bethanechol chloride 10 Drugs for urinary retention 2402 0.00 0.00 0.00 6.79
Mercaptamine hydrochloride 2 Tear deficiency, eye lubricant/astringent 1139 0.00 0.00 0.00 5.56
Meloxicam 448 Non-steroidal anti-inflammatory drugs 1875 0.24 0.03 0.04 4.62

Prescribing where Beacon Medical Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Macrogol 3350 1416 Osmotic laxatives 2793 0.51 0.70 0.10 -2.03
Macrogol compound oral powder sachets NPF sugar free : 443
Movicol oral powder 13.8g sachets lemon & lime : 209
Movicol Paediatric Plain oral powder 6.9g sachets : 57
Laxido Orange oral powder sachets sugar free : 567
Movicol Chocolate oral powder 13.9g sachets : 2
Movicol-Half oral powder 6.9g sachets : 1
Macrogol compound half-strength oral pdr sach NPF sugar free : 14
Macrogol compound oral powder sachets NPF : 4
CosmoCol Paediatric oral powder 6.9g sachets : 4
Movicol Paediatric Chocolate oral powder 6.9g sachets : 13
Movicol Plain oral powder 13.7g sachets : 26
CosmoCol Orange Flavour oral powder sachets : 25
Macrogol 3350 oral powder 8.5g sachets sugar free : 6
CosmoCol Plain oral powder sachets : 6
Laxido Paediatric Plain oral powder 6.9g sachets : 24
Laxido Orange oral powder sachets : 5
CosmoCol Orange Lemon and Lime oral powder sachets : 5
CosmoCol Lemon and Lime Flavour oral powder sachets : 5
Naproxen 917 Non-steroidal anti-inflammatory drugs 1875 0.49 0.69 0.10 -1.97
Rifampicin 0 Antituberculosis drugs 1 0.00 0.73 0.40 -1.81
Lymecycline 69 Tetracyclines 1070 0.06 0.29 0.13 -1.75
Urea hydrogen peroxide 1 Removal of ear wax and other substances 4 0.25 0.83 0.34 -1.73