Static outliers for Market Rasen Surgery

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 Market Rasen Surgery is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Diphenhydramine hydrochloride 2 Topical local anaesthetics and antipruritics 15 0.13 0.00 0.00 179.79
Telmisartan with diuretic 92 Angiotensin-II receptor antagonists 3043 0.03 0.00 0.00 7.27
Risperidone 11 Antipsychotic depot injections 11 1.00 0.08 0.21 4.32
Other oral iron preparations 27 Oral iron 1122 0.02 0.00 0.01 3.50
Other calcium supplement preparations 6 Calcium supplements 13 0.46 0.04 0.12 3.36

Prescribing where Market Rasen Surgery is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Calcium carbonate 7 Calcium supplements 13 0.54 0.95 0.13 -3.10
Salbutamol 1579 Selective beta(2)-agonists 1924 0.82 0.91 0.05 -1.87
Baclofen 122 Skeletal muscle relaxants 247 0.49 0.83 0.18 -1.80
Fusidic acid 39 Antibacterial preparations also used systemically 86 0.45 0.72 0.15 -1.76
Doxycycline hyclate 197 Tetracyclines 476 0.41 0.63 0.14 -1.62