Static outliers for Savita Medical Centre

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 Savita Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Nabumetone 23 Non-steroidal anti-inflammatory drugs 197 0.12 0.00 0.01 22.30
Trimetazidine hydrochloride 2 Calcium-channel blockers 782 0.00 0.00 0.00 16.19
Propafenone hydrochloride 4 Drugs for arrhythmias 5 0.80 0.02 0.05 14.47
Zuclopenthixol hydrochloride 52 Antipsychotic drugs 440 0.12 0.01 0.01 7.96
Paraffin soft white 5 Emollients 110 0.05 0.00 0.01 7.86

Prescribing where Savita Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sildenafil (Erectile Dysfunction) 18 Drugs for erectile dysfunction 41 0.44 0.77 0.09 -3.51
Other multivitamin preparations 13 Multivitamin preparations 59 0.22 0.81 0.21 -2.83
Colecalciferol 532 Vitamin D 593 0.90 0.96 0.02 -2.67
Colecalciferol 800unit capsules : 31
Colecalciferol 1,000unit capsules : 34
Accrete D3 tablets : 52
Adcal-D3 750mg/200unit caplets : 38
Calcichew D3 Forte chewable tablets : 33
Evacal D3 1500mg/400unit chewable tablets : 162
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 2
Colecalciferol 25,000unit tablets : 2
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 1
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 1
Desunin 800unit tablets : 18
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 27
Colecalciferol 20,000unit capsules : 8
Fultium-D3 20,000unit capsules : 8
Colecalciferol 400unit capsules : 3
Colecalciferol 800unit tablets : 3
Pro D3 2,000units/ml Vegan liquid drops : 3
Calcichew D3 chewable tablets : 3
Adcal-D3 Lemon chewable tablets : 26
Colecalciferol 20,000unit tablets : 7
Colecalciferol 200units/drop oral drops : 7
Adcal-D3 chewable tablets tutti frutti : 7
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 21
Hux D3 20,000unit capsules : 25
Accrete D3 One a Day 1000mg/880unit chewable tablets : 5
Fultium-D3 800unit capsules : 5
Donepezil hydrochloride 0 Drugs for dementia 6 0.00 0.49 0.19 -2.65
Clopidogrel 103 Antiplatelet drugs 646 0.16 0.32 0.06 -2.58