Static outliers for Hammond Road 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 Hammond Road Surgery is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Buserelin 1 Prostate cancer and gonadorelin analogues 4 0.25 0.00 0.00 1028.80
Tretinoin 4 Topical preparations for acne 41 0.10 0.00 0.00 230.91
Lithium citrate 5 Drugs used for mania and hypomania 5 1.00 0.01 0.03 38.75
Lurasidone 36 Antipsychotic drugs 161 0.22 0.00 0.01 28.49
Raloxifene hydrochloride 2 Oestrogens and Hormone Replacement Therapy 3 0.67 0.01 0.03 22.52

Prescribing where Hammond Road Surgery is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sodium cromoglicate 0 Cromoglycate and related therapy 1 0.00 0.97 0.15 -6.27
Baclofen 0 Skeletal muscle relaxants 2 0.00 0.83 0.18 -4.49
Colecalciferol 1092 Vitamin D 1271 0.86 0.96 0.02 -4.20
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 101
Adcal-D3 Lemon chewable tablets : 63
Adcal-D3 750mg/200unit caplets : 252
Calceos 500mg/400unit chewable tablets : 41
Fultium-D3 800unit capsules : 140
Hux D3 20,000unit capsules : 195
Stexerol-D3 25,000unit tablets : 130
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 2
Fultium-D3 3,200unit capsules : 2
Fultium-D3 20,000unit capsules : 1
InVita D3 2,400units/ml oral drops : 28
Pro D3 20,000unit capsules : 4
InVita D3 25,000units/1ml oral solution : 4
Stexerol-D3 1,000unit tablets : 18
Colecalciferol 800unit tablets : 13
Pro D3 2,000units/ml liquid : 3
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 3
Pro D3 800unit capsules : 12
Colecalciferol 20,000unit capsules : 6
Calcichew D3 Forte chewable tablets : 6
Adcal-D3 chewable tablets tutti frutti : 20
Colecalciferol 400unit / Calcium carbonate 1.25g tablets : 24
Accrete D3 tablets : 24
Neomycin sulfate 8 Nasal preparations for infection 23 0.35 0.84 0.14 -3.42
Somatropin 0 Hypothalamic & anterior pituitary hormone & antioestrogens 10 0.00 0.90 0.27 -3.31