Static outliers for Meopham 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 Meopham Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Mianserin hydrochloride 2 Tricyclic and related antidepressant drugs 1013 0.00 0.00 0.00 7.31
Undecenoates 5 Antifungal preparations 102 0.05 0.00 0.01 7.02
Orphenadrine hydrochloride 5 Antimuscarinic drugs used in parkinsonism 22 0.23 0.01 0.03 6.39
Mebeverine hydrochloride compound preparations 26 Antispasmodic and other drugs altering gut motility 176 0.15 0.01 0.02 6.03
Strontium ranelate 5 Bisphosphonates and other drugs 627 0.01 0.00 0.00 4.87

Prescribing where Meopham Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Beclometasone dipropionate 399 Corticosteroids (respiratory) 1598 0.25 0.57 0.12 -2.69
Qvar 100 inhaler : 32
Clenil Modulite 50micrograms/dose inhaler : 52
Clenil Modulite 100micrograms/dose inhaler : 120
Clenil Modulite 200micrograms/dose inhaler : 52
Fostair 100micrograms/dose / 6micrograms/dose inhaler : 55
Beclometasone 100mcg/dose breath actuated inhaler CFC free : 2
Qvar 100 Autohaler : 2
Qvar 50 Autohaler : 1
Fostair 200micrograms/dose / 6micrograms/dose inhaler : 28
Qvar 50 inhaler : 8
Qvar 50micrograms/dose Easi-Breathe inhaler : 3
Qvar 100micrograms/dose Easi-Breathe inhaler : 3
Fostair NEXThaler 200microg/dose / 6microg/dose dry pdr inh : 7
Beclometasone 100microg/Formoterol 6microg/dose inh CFCfree : 11
Beclometasone 100micrograms/dose inhaler CFC free : 6
Clenil Modulite 250micrograms/dose inhaler : 6
Fostair NEXThaler 100microg/dose / 6microg/dose dry pdr inh : 6
Beclometasone 50micrograms/dose inhaler CFC free : 5
Sertraline hydrochloride 726 Selective serotonin re-uptake inhibitors 2989 0.24 0.45 0.09 -2.40
Zinc oxide 1 Soothing haemorrhoidal preparations 7 0.14 0.77 0.27 -2.36
Mirtazapine 508 Other antidepressant drugs 1493 0.34 0.57 0.11 -2.14
Oral rehydration salts 3 Oral sodium and water 53 0.06 0.68 0.31 -2.02