Static outliers for Bacon Lane 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 Bacon Lane Surgery is higher than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Ampicillin☰	2	Broad-spectrum penicillins	226	0.01	0.00	0.00	10.33
Ampicillin 250mg capsules : 2
Low protein grains/flours☰	5	Foods for special diets	179	0.03	0.00	0.00	5.93
Promin low protein all purpose baking mix : 5
Torasemide☰	24	Loop diuretics	887	0.03	0.00	0.00	5.41
Torasemide 10mg tablets : 24
Paroxetine hydrochloride☰	139	Selective serotonin re-uptake inhibitors	1107	0.13	0.03	0.02	5.19
Paroxetine 20mg tablets : 74 Paroxetine 30mg tablets : 36 Paroxetine 40mg tablets : 2 Paroxetine 10mg tablets : 27
Magnesium hydroxide☰	2	Antacids and simeticone	3	0.67	0.03	0.14	4.47
Magnesium hydroxide 7.45-8.35% oral suspension BP : 2

Prescribing where Bacon Lane Surgery is lower than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Desogestrel☰	47	Oral progestogen-only contraceptives	62	0.76	0.94	0.05	-3.32
Desogestrel 75microgram tablets : 31 Cerelle 75microgram tablets : 1 Cerazette 75microgram tablets : 3 Zelleta 75microgram tablets : 12
Procyclidine hydrochloride☰	13	Antimuscarinic drugs used in parkinsonism	52	0.25	0.84	0.21	-2.84
Kemadrin 5mg tablets : 13
Calcium carbonate☰	7	Calcium supplements	12	0.58	0.95	0.13	-2.76
Calcium carbonate 2.5g chewable tablets sugar free : 4 Calcium carbonate 1.25g effervescent tablets sugar free : 3
Folic acid☰	403	Drugs used in megaloblastic anaemias	1118	0.36	0.70	0.16	-2.13
Folic acid 5mg tablets : 394 Folic acid 400microgram tablets : 2 Folic acid 2.5mg/5ml oral solution sugar free : 7
Naftidrofuryl oxalate☰	0	Peripheral vasodilators and related drugs	5	0.00	0.66	0.39	-1.69