Static outliers for Jubilee Gardens 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 Jubilee Gardens Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Paracetamol and ibuprofen 1 Non-opioid analgesics and compound preparations 1505 0.00 0.00 0.00 15.34
Alclometasone dipropionate 1 Topical corticosteroids 640 0.00 0.00 0.00 14.84
Iron and folic acid 37 Oral iron 667 0.06 0.00 0.01 8.80
Patiromer calcium 4 Oral potassium 8 0.50 0.01 0.06 7.78
Zolpidem tartrate 120 Hypnotics 267 0.45 0.07 0.07 5.50

Prescribing where Jubilee Gardens Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Potassium chloride 4 Oral potassium 8 0.50 0.98 0.12 -4.04
Cabergoline 0 Bromocriptine and other dopaminergic drugs 1 0.00 0.86 0.27 -3.16
Methylphenidate hydrochloride 0 CNS Stimulants and drugs used for ADHD 12 0.00 0.65 0.21 -3.15
Water for injection 0 Electrolytes and water 1 0.00 0.82 0.26 -3.14
Colecalciferol 1299 Vitamin D 1455 0.89 0.96 0.02 -2.84
Colecalciferol 20,000unit capsules : 29
Accrete D3 tablets : 144
Adcal-D3 chewable tablets tutti frutti : 103
Adcal-D3 750mg/200unit caplets : 137
Calceos 500mg/400unit chewable tablets : 82
Fultium-D3 800unit capsules : 354
Fultium-D3 20,000unit capsules : 254
Desunin 800unit tablets : 30
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 2
Accrete D3 One a Day 1000mg/880unit chewable tablets : 2
Calcichew D3 chewable tablets : 2
Plenachol D3 20,000unit capsules : 2
Colecalciferol 1,000unit tablets : 1
Colecalciferol 10,000unit tablets : 1
Pro D3 800unit capsules : 1
SunVit-D3 20,000unit tablets : 1
SunVit-D3 800unit tablets : 1
Fultium-D3 2,740units/ml oral drops : 1
Aciferol D3 400unit tablets : 1
Plenachol D3 40,000unit capsules : 1
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 4
Colecalciferol 10,000units/ml oral drops sugar free : 4
Hux D3 20,000unit capsules : 13
Evacal D3 1500mg/400unit chewable tablets : 8
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 3
Colecalciferol 10,000units/ml oral solution sugar free : 3
Colecalciferol 2,400units/ml oral drops sugar free : 3
Pro D3 1,000unit capsules : 3
Hux D3 3,200unit capsules : 3
InVita D3 25,000units/1ml oral solution : 26
Colecalciferol 40,000unit capsules : 7
Fultium-D3 3,200unit capsules : 7
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 11
Adcal-D3 Lemon chewable tablets : 6
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 5
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 5
Calcichew D3 Forte chewable tablets : 5
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 5
InVita D3 2,400units/ml oral drops : 5
Stexerol-D3 1,000unit tablets : 5
Colecalciferol 800unit capsules : 19