Static outliers for The Spalding Gp 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 The Spalding Gp Surgery is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Shingles (H/Z) 2 Vaccines and antisera 3 0.67 0.01 0.06 11.25
Calcitriol 22 Vitamin D 475 0.05 0.00 0.00 11.19
Tafluprost 9 Treatment of glaucoma 96 0.09 0.01 0.01 8.14
Ergocalciferol 22 Vitamin D 475 0.05 0.00 0.01 6.90
Azelaic acid 4 Topical preparations for acne 9 0.44 0.07 0.06 6.27

Prescribing where The Spalding Gp Surgery is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 412 Vitamin D 475 0.87 0.96 0.02 -3.87
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 79
Adcal-D3 chewable tablets tutti frutti : 156
Adcal-D3 750mg/200unit caplets : 51
Colecalciferol 800unit tablets : 2
Colecalciferol 2,000unit chewable tablets : 1
Hux D3 20,000unit capsules : 1
Evacal D3 1500mg/400unit chewable tablets : 1
Calci-D 1000mg/1,000unit chewable tablets : 1
Fultium-D3 800unit capsules : 14
Colecalciferol 800unit capsules : 28
Colecalciferol 400unit tablets : 4
Calcichew D3 chewable tablets : 4
Calcichew D3 Forte chewable tablets : 4
Colecalciferol 400unit capsules : 3
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 7
Adcal-D3 Lemon chewable tablets : 16
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 10
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 10
Strivit-D3 800unit capsules : 10
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 5
Fultium-D3 3,200unit capsules : 5
Levothyroxine sodium 1167 Thyroid hormones 1180 0.99 1.00 0.00 -3.24
Benzoyl peroxide and clindamycin phosphate 0 Topical preparations for acne 9 0.00 0.38 0.14 -2.73
Neomycin sulfate 1 Nasal preparations for infection 2 0.50 0.84 0.14 -2.37
Lithium carbonate 0 Drugs used for mania and hypomania 27 0.00 0.61 0.28 -2.19