Static outliers for Cassidy Road 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 Cassidy Road Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Pimozide 36 Antipsychotic drugs 843 0.04 0.00 0.00 22.18
Aspirin 26 Non-opioid analgesics and compound preparations 609 0.04 0.00 0.00 15.89
Phosphates 2 Bowel cleansing preparations 2 1.00 0.01 0.07 14.58
Buprenorph hydrochloride/naloxone hydrochloride 4 Opioid dependence 4 1.00 0.01 0.07 13.66
Sodium benzoate 1 Mouth-washes, gargles and dentifrices 9 0.11 0.00 0.01 12.63

Prescribing where Cassidy Road Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ispaghula husk 11 Bulk-forming laxatives 18 0.61 0.96 0.07 -4.75
Water for injection 0 Electrolytes and water 5 0.00 0.82 0.26 -3.14
Colecalciferol 1120 Vitamin D 1261 0.89 0.96 0.02 -3.03
Colecalciferol 800unit capsules : 29
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 67
Colecalciferol 20,000unit capsules : 47
Accrete D3 tablets : 94
Adcal-D3 chewable tablets tutti frutti : 92
Adcal-D3 750mg/200unit caplets : 259
Calcichew D3 Forte chewable tablets : 45
Fultium-D3 800unit capsules : 162
Fultium-D3 20,000unit capsules : 130
Stexerol-D3 25,000unit tablets : 39
Calci-D 1000mg/1,000unit chewable tablets : 48
Colecalciferol 1,000unit capsules : 2
Valupak Vitamin D3 1,000unit tablets : 2
Adcal-D3 Lemon chewable tablets : 2
Fultium-D3 2,740units/ml oral drops : 2
Colecalciferol 3,000unit tablets : 1
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 1
Colecalciferol 800unit tablets : 1
Colecalciferol 50,000unit tablets : 1
Pro D3 2,000units/ml liquid : 1
Accrete D3 One a Day 1000mg/880unit chewable tablets : 1
SunVit-D3 2,000units/ml oral solution : 1
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 9
InVita D3 25,000units/1ml oral solution : 4
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 8
Colecalciferol 10,000unit tablets : 3
Colecalciferol 40,000unit capsules : 3
Calceos 500mg/400unit chewable tablets : 3
Fultium-D3 3,200unit capsules : 3
InVita D3 2,400units/ml oral drops : 3
Hux D3 20,000unit capsules : 25
Colecalciferol 1,000unit tablets : 6
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 6
Natecal D3 600mg/400unit chewable tablets : 20
Hydralazine hydrochloride 0 Vasodilator antihypertensive drugs 1 0.00 0.85 0.28 -3.01
Other emollient preparations 97 Emollients 138 0.70 0.89 0.07 -2.66