Static outliers for The Golborne 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 The Golborne Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Griseofulvin 1 Antifungal preparations 70 0.01 0.00 0.00 34.97
Methylcellulose 3 Bulk-forming laxatives 34 0.09 0.00 0.01 12.61
Liquid paraffin 41 Emollient bath and shower preparations 67 0.61 0.03 0.07 8.13
Bisacodyl 366 Stimulant laxatives 618 0.59 0.14 0.10 4.59
Dicycloverine hydrochloride compound preparations 5 Antispasmodic and other drugs altering gut motility 65 0.08 0.00 0.02 4.56

Prescribing where The Golborne Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ivermectin 0 Topical preparation for rosacea 1 0.00 0.88 0.24 -3.72
Bendroflumethiazide 21 Thiazides and related diuretics 973 0.02 0.58 0.16 -3.51
Colecalciferol 1359 Vitamin D 1545 0.88 0.96 0.02 -3.37
Accrete D3 tablets : 91
Fultium-D3 20,000unit capsules : 48
Hux D3 20,000unit capsules : 74
InVita D3 25,000units/1ml oral solution : 46
InVita D3 800unit capsules : 130
Stexerol-D3 25,000unit tablets : 54
Calci-D 1000mg/1,000unit chewable tablets : 772
Colecalciferol 20,000unit capsules : 2
Adcal-D3 750mg/200unit caplets : 2
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 1
Colecalciferol 20,000unit tablets : 1
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 1
Calceos 500mg/400unit chewable tablets : 4
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 13
Accrete D3 One a Day 1000mg/880unit chewable tablets : 8
Adcal-D3 chewable tablets tutti frutti : 8
Colecalciferol 800unit capsules : 17
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 16
Adcal-D3 Lemon chewable tablets : 6
Calcichew D3 Forte chewable tablets : 6
Desunin 800unit tablets : 6
Fultium-D3 800unit capsules : 24
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 5
Fultium-D3 3,200unit capsules : 5
OsteoCaps D3 1,000unit capsules : 19
Water for injection 0 Electrolytes and water 2 0.00 0.82 0.26 -3.14
Hydralazine hydrochloride 0 Vasodilator antihypertensive drugs 2 0.00 0.85 0.28 -3.01