Static outliers for Penistone Group Pms 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 Penistone Group Pms Practice is higher than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score
Formaldehyde	3	Preparations for warts and calluses	8	0.38	0.00	0.01	39.45
Formaldehyde (Buffered) 4% solution : 3
Pimozide	22	Antipsychotic drugs	831	0.03	0.00	0.00	13.70
Pimozide 4mg tablets : 22
Olmesartan medoxomil/amlodipine	161	Angiotensin-II receptor antagonists	4424	0.04	0.00	0.00	11.20
Olmesartan medoxomil 20mg / Amlodipine 5mg tablets : 31 Olmesartan medoxomil 40mg / Amlodipine 5mg tablets : 30 Olmesartan medoxomil 40mg / Amlodipine 10mg tablets : 53 Sevikar 20mg/5mg tablets : 17 Sevikar 40mg/10mg tablets : 20 Sevikar 40mg/5mg tablets : 10
Olmesartan medoxomil	1275	Angiotensin-II receptor antagonists	4424	0.29	0.02	0.03	8.00
Olmesartan medoxomil 10mg tablets : 439 Olmesartan medoxomil 20mg tablets : 463 Olmesartan medoxomil 40mg tablets : 362 Olmetec 40mg tablets : 6 Olmetec 10mg tablets : 5
Diclofenac sodium	2	Ocular diagnostic & peri-operative prepn & photodynamic tt	2	1.00	0.03	0.13	7.71
Diclofenac 0.1% eye drops 0.3ml unit dose preservative free : 2

Prescribing where Penistone Group Pms Practice is lower than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score
Co-cyprindiol (Cyprote acetate/ethinylestradiol)	0	Oral preparations for acne	2	0.00	0.97	0.13	-7.22

Aciclovir	53	Antiviral preparations	54	0.98	1.00	0.01	-3.20
Aciclovir 5% cream : 53
Brinzolamide	44	Treatment of glaucoma	1622	0.03	0.09	0.04	-1.70
Brinzolamide 10mg/ml eye drops : 35 Azopt 10mg/ml eye drops : 9
Gentamicin sulfate	0	Aminoglycosides	2	0.00	0.72	0.44	-1.65

Ganciclovir	0	Antivirals	2	0.00	0.68	0.42	-1.60