Static outliers for Streatham Common Group 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 Streatham Common Group Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Gluten free/low protein biscuits 20 Foods for special diets 106 0.19 0.00 0.01 16.95
Gluten free/low protein mixes 6 Foods for special diets 106 0.06 0.00 0.01 9.62
Mefloquine hydrochloride 1 Antimalarials 89 0.01 0.00 0.00 8.79
Beclometasone dipropionate 3 Topical corticosteroids 504 0.01 0.00 0.00 7.82
Gluten free/low protein bread 18 Foods for special diets 106 0.17 0.01 0.02 7.78

Prescribing where Streatham Common Group Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Co-amilofruse (Amiloride hydrochloride/frusemide) 0 Potassium sparing diuretics and compounds 3 0.00 0.68 0.33 -2.07
Colecalciferol 1659 Vitamin D 1819 0.91 0.96 0.02 -2.07
Colecalciferol 800unit capsules : 214
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 61
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 158
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 564
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 56
Colecalciferol 800unit tablets : 87
Adcal-D3 chewable tablets tutti frutti : 187
Adcal-D3 750mg/200unit caplets : 35
Stexerol-D3 1,000unit tablets : 36
Fultium-D3 800unit capsules : 2
Fultium-D3 20,000unit capsules : 2
Colecalciferol 400unit capsules : 1
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 1
Colecalciferol 40,000unit capsules : 1
Colecalciferol 2,000unit tablets : 1
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 2,200unit capsules : 1
Adcal-D3 Lemon chewable tablets : 1
Plenachol D3 20,000unit capsules : 1
ColeDose D3 50,000unit capsules : 1
Colecalciferol 1,000unit tablets : 23
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 23
Desunin 800unit tablets : 23
Colecalciferol 20,000unit tablets : 4
Calceos 500mg/400unit chewable tablets : 4
Thorens 10,000units/ml oral drops : 4
Evacal D3 1500mg/400unit chewable tablets : 8
TheiCal-D3 1000mg/880unit chewable tablets : 22
Plenachol D3 40,000unit capsules : 3
Colecalciferol 1,000unit capsules : 12
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 12
Calcichew D3 chewable tablets : 7
Accrete D3 tablets : 11
Colecalciferol 20,000unit capsules : 20
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 24
Colecalciferol 400unit tablets : 24
Calcichew D3 Forte chewable tablets : 24
Neomycin sulfate 11 Nasal preparations for infection 19 0.58 0.84 0.14 -1.82
Pregabalin 186 Control of epilepsy 1464 0.13 0.27 0.08 -1.80
Hypromellose 8 Tear deficiency, eye lubricant/astringent 44 0.18 0.45 0.15 -1.78