Static outliers for Yiewsley Family Practice

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 Yiewsley Family Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Liquid paraffin 65 Emollient bath and shower preparations 141 0.46 0.03 0.07 6.00
Flubiprofen 2 Drugs for oral ulceration and inflammation 28 0.07 0.00 0.01 5.33
Dronedarone hydrochloride 26 Drugs for arrhythmias 77 0.34 0.02 0.06 5.09
Prednisolone sodium phosphate 1 Corticosteroids 1 1.00 0.09 0.20 4.57
Dutasteride 48 Male sex hormones and antagonists 129 0.37 0.06 0.07 4.33

Prescribing where Yiewsley Family Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Finasteride 68 Male sex hormones and antagonists 129 0.53 0.82 0.12 -2.53
Urea hydrogen peroxide 0 Removal of ear wax and other substances 5 0.00 0.83 0.34 -2.47
Macrogol 3350 255 Osmotic laxatives 531 0.48 0.70 0.10 -2.30
Colecalciferol 1187 Vitamin D 1302 0.91 0.96 0.02 -2.08
Colecalciferol 800unit capsules : 62
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 335
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 36
Colecalciferol 20,000unit tablets : 34
Colecalciferol 20,000unit capsules : 126
Adcal-D3 chewable tablets tutti frutti : 99
Adcal-D3 Lemon chewable tablets : 41
Adcal-D3 750mg/200unit caplets : 57
SunVit-D3 20,000unit capsules : 63
Fultium-D3 800unit capsules : 66
Hux D3 20,000unit capsules : 37
Colecalciferol 3,000unit tablets : 2
Colecalciferol 400unit capsules : 2
Colecalciferol 200units/drop oral drops : 2
Pro D3 2,000units/ml liquid drops : 2
InVita D3 2,400units/ml oral drops : 2
Colecalciferol 4,000unit tablets : 1
Pro D3 10,000unit capsules : 1
SunVit-D3 1,000unit tablets : 1
SunVit-D3 2,000units/ml oral drops : 1
SunVit-D3 400unit tablets : 1
SunVit-D3 10,000unit capsules : 1
Fultium-D3 2,740units/ml oral drops : 1
InVita D3 25,000units/1ml oral solution : 1
Colecalciferol 800unit tablets : 18
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 13
Calcichew D3 Forte chewable tablets : 27
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 8
Colecalciferol 25,000units/1ml soln ud amp sugar free : 3
Colecalciferol 400units/ml oral drops sugar free : 3
InVita D3 800unit capsules : 3
TheiCal-D3 1000mg/880unit chewable tablets : 3
Pro D3 20,000unit capsules : 7
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 21
Colecalciferol 2,000unit tablets : 11
Calcichew D3 chewable tablets : 25
Colecalciferol 2,400units/ml oral drops sugar free : 6
BabyD 1,000units/ml oral solution : 6
Evacal D3 1500mg/400unit chewable tablets : 20
Colecalciferol 2,740units/ml oral drops sugar free : 10
Calceos 500mg/400unit chewable tablets : 24
Colecalciferol 2,000units/ml oral drops sugar free : 5
Budesonide 0 Corticosteroids 1 0.00 0.70 0.34 -2.08