Static outliers for Waterside 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 Waterside Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Pridinol mesilate 3 Skeletal muscle relaxants 20 0.15 0.00 0.01 15.65
Diazoxide 3 Treatment of hypoglycaemia 7 0.43 0.00 0.04 11.80
Oxycodone hydrochloride/naloxone hydrochloride 14 Opioid analgesics 240 0.06 0.00 0.01 11.25
Magnesium trisilicate 1 Antacids and simeticone 1 1.00 0.03 0.14 7.11
Sodium bicarbonate 5 Electrolytes and water 22 0.23 0.00 0.04 6.34

Prescribing where Waterside Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 852 Vitamin D 973 0.88 0.96 0.02 -3.53
Colecalciferol 800unit capsules : 29
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 29
Accrete D3 tablets : 100
Adcal-D3 chewable tablets tutti frutti : 30
Adcal-D3 750mg/200unit caplets : 142
Calceos 500mg/400unit chewable tablets : 120
Calcichew D3 chewable tablets : 30
Fultium-D3 800unit capsules : 140
InVita D3 25,000units/1ml oral solution : 77
Colecalciferol 2,000units/ml oral drops sugar free : 1
Pro D3 1,000unit capsules : 1
Pro D3 2,500unit capsules : 1
Calfovit D3 oral powder sachets : 1
DLux 400 oral spray : 1
Pro D3 forte 3,000units/ml liquid : 1
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 14
Valupak Vitamin D3 1,000unit tablets : 9
Fultium-D3 3,200unit capsules : 9
Fultium-D3 20,000unit capsules : 9
Colecalciferol 1,000unit tablets : 4
Colecalciferol 20,000unit capsules : 3
Aciferol D3 10,000unit tablets : 3
Stexerol-D3 25,000unit tablets : 7
Calcichew D3 Forte chewable tablets : 25
Stexerol-D3 1,000unit tablets : 25
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 6
Colecalciferol 20,000unit tablets : 20
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 5
Colecalciferol 400units/dose oral spray sugar free : 5
Hux D3 20,000unit capsules : 5
Diazepam 26 Anxiolytics 78 0.33 0.75 0.14 -3.10
Hydralazine hydrochloride 0 Vasodilator antihypertensive drugs 2 0.00 0.85 0.28 -3.01
Prednisolone 94 Use of corticosteroids 132 0.71 0.88 0.06 -2.66
Allopurinol 130 Gout and cytotoxic induced hyperiuicaemia 172 0.76 0.89 0.05 -2.60