Static outliers for Grove 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 Grove Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Inosine pranobex 3 Herpes simplex and varicella-zoster 57 0.05 0.0 0.0 34.70
Isometheptene mucate 4 Non-opioid analgesics and compound preparations 1192 0.00 0.0 0.0 18.16
Nicotinates 6 Rubefacients, topical NSAIDS, capsaicin and poultice 402 0.01 0.0 0.0 12.86
Proguanil hydrochloride with atovaquone 1 Antimalarials 45 0.02 0.0 0.0 12.80
Hydrocortisone sodium succinate 4 Use of corticosteroids 158 0.03 0.0 0.0 8.48

Prescribing where Grove Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Isosorbide mononitrate 56 Nitrates 145 0.39 0.73 0.11 -3.22
Potassium permanganate 2 Oxidisers and dyes 7 0.29 0.94 0.22 -2.93
Urea hydrogen peroxide 0 Removal of ear wax and other substances 1 0.00 0.83 0.34 -2.47
Apixaban 28 Oral anticoagulants 313 0.09 0.40 0.14 -2.19
Colecalciferol 796 Vitamin D 875 0.91 0.96 0.02 -2.16
Colecalciferol 800unit capsules : 82
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 224
Colecalciferol 800unit tablets : 79
Adcal-D3 chewable tablets tutti frutti : 77
Adcal-D3 750mg/200unit caplets : 43
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 2
ColeKal-D3 800unit tablets : 2
Colecalciferol 50,000unit tablets : 1
Colecalciferol 200units/drop oral drops : 1
Pro D3 400unit capsules : 1
Accrete D3 tablets : 1
SunVit-D3 10,000unit capsules : 1
ColeKal-D3 800unit capsules : 1
Colecalciferol 400unit capsules : 28
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 9
Evacal D3 1500mg/400unit chewable tablets : 9
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 4
Colecalciferol 1,000unit tablets : 18
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 8
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 22
Desunin 800unit tablets : 22
Colecalciferol 2,000unit tablets : 12
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 7
Adcal-D3 Lemon chewable tablets : 7
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 7
Colecalciferol 20,000unit capsules : 21
Calcichew D3 chewable tablets : 11
Calcichew D3 Forte chewable tablets : 25
Valupak Vitamin D3 1,000unit tablets : 6
Fultium-D3 800unit capsules : 6
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 15
Colecalciferol 20,000unit tablets : 24
Colecalciferol 1,000unit capsules : 5
Colecalciferol 40,000unit capsules : 5
Colecalciferol 400unit tablets : 5
OsteoCaps D3 1,000unit capsules : 5