Static outliers for Falmouth Road 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 Falmouth Road Group Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Compound alginates and proprietary indigestion preparations 4 Compound Alginates and proprietary indigestion preparations 46 0.09 0.00 0.00 17.26
Beclometasone dipropionate 3 Topical corticosteroids 537 0.01 0.00 0.00 7.32
Emulsifying wax 53 Emollients 260 0.20 0.01 0.03 6.60
Vortioxetine 68 Other antidepressant drugs 700 0.10 0.01 0.02 4.84
Carbamazepine 239 Control of epilepsy 1116 0.21 0.07 0.03 4.80

Prescribing where Falmouth Road Group Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Alginic acid compound preparations 42 Compound Alginates and proprietary indigestion preparations 46 0.91 1.00 0.01 -6.24
Prednisolone 113 Use of corticosteroids 166 0.68 0.88 0.06 -3.16
Sodium cromoglicate 11 Other anti-inflammatory preparations 91 0.12 0.67 0.18 -2.99
Ciprofloxacin 7 Quinolones 15 0.47 0.86 0.15 -2.63
Colecalciferol 1009 Vitamin D 1121 0.90 0.96 0.02 -2.55
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 129
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 253
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 30
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 33
Adcal-D3 chewable tablets tutti frutti : 138
Adcal-D3 750mg/200unit caplets : 123
Calcichew D3 Forte chewable tablets : 57
Fultium-D3 20,000unit capsules : 39
Desunin 800unit tablets : 66
Colecalciferol 1,000unit capsules : 2
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 2
Stexerol-D3 25,000unit tablets : 2
Colecalciferol 20,000unit tablets : 1
Colecalciferol 40,000unit capsules : 1
Colecalciferol 10,000units/ml oral drops sugar free : 1
Pro D3 2,000units/ml liquid drops : 1
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 1
Fultium-D3 2,740units/ml oral drops : 1
Desunin 4,000unit tablets : 1
Plenachol D3 20,000unit capsules : 1
Plenachol D3 40,000unit capsules : 1
InVita D3 2,400units/ml oral drops : 1
Colecalciferol 20,000unit capsules : 4
Stexerol-D3 1,000unit tablets : 4
Fultium-D3 800unit capsules : 27
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 3
Colecalciferol 800unit tablets : 3
Adcal-D3 Lemon chewable tablets : 3
SunVit-D3 800unit tablets : 26
Colecalciferol 1,000unit tablets : 7
Calcichew D3 chewable tablets : 7
Thorens 10,000units/ml oral drops : 7
Colecalciferol 800unit capsules : 10
Valupak Vitamin D3 1,000unit tablets : 24