Static outliers for Grove Village 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 Grove Village Medical Centre is higher than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Olsalazine sodium☰	24	Aminosalicylates	102	0.24	0.00	0.01	16.77
Olsalazine 500mg tablets : 24
Dantrolene sodium☰	25	Skeletal muscle relaxants	61	0.41	0.02	0.06	7.04
Dantrolene 25mg capsules : 25
Raltegravir☰	1	HIV infection	2	0.50	0.01	0.07	6.71
Raltegravir 600mg tablets : 1
Buspirone hydrochloride☰	185	Anxiolytics	435	0.43	0.03	0.06	6.18
Buspirone 5mg tablets : 99 Buspirone 10mg tablets : 86
Typhoid☰	4	Vaccines and antisera	6	0.67	0.05	0.11	5.77
Typhim Vi 25micrograms/0.5ml vacc inj pre-filled syringes : 4

Prescribing where Grove Village Medical Centre is lower than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Calcium carbonate☰	6	Calcium supplements	11	0.55	0.95	0.13	-3.04
Calcium carbonate 1.5g chewable tablets sugar free : 2 Calcichew 500mg chewable tablets : 1 Adcal 1500mg chewable tablets : 3
Diazepam☰	182	Anxiolytics	435	0.42	0.75	0.14	-2.47
Diazepam 2mg tablets : 63 Diazepam 5mg tablets : 109 Diazepam 10mg/2.5ml rectal solution tube : 5 Diazepam 10mg tablets : 5
Citalopram hydrobromide☰	270	Selective serotonin re-uptake inhibitors	1992	0.14	0.32	0.08	-2.20
Citalopram 20mg tablets : 127 Citalopram 10mg tablets : 99 Citalopram 40mg tablets : 44
Clotrimazole☰	8	Antifungal preparations	111	0.07	0.41	0.16	-2.07
Clotrimazole 1% cream : 8
Sulfasalazine☰	4	Aminosalicylates	102	0.04	0.33	0.14	-2.05
Sulfasalazine 500mg gastro-resistant tablets : 4