Static outliers for Tessa Jowell Gp Surgery

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 Tessa Jowell Gp Surgery is higher than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score
Isotretinoin	73	Oral preparations for acne	79	0.92	0.03	0.13	6.65
Isotretinoin 20mg capsules : 53 Roaccutane 20mg capsules : 2 Isotretinoin 10mg capsules : 18
Rasagiline mesilate	78	Dopaminergic drugs used in parkinsonism	210	0.37	0.05	0.05	6.64
Rasagiline 1mg tablets : 78
Ciprofloxain/dexameth	73	Otitis externa	206	0.35	0.05	0.06	4.87
Ciprofloxacin 0.3% / Dexamethasone 0.1% ear drops : 73
Rufinamide	10	Control of epilepsy	1524	0.01	0.00	0.00	3.93
Rufinamide 100mg tablets : 5 Rufinamide 400mg tablets : 5
Eplerenone	275	Potassium-sparing diuretics and aldosterone antagonists	358	0.77	0.25	0.13	3.87
Eplerenone 25mg tablets : 200 Eplerenone 50mg tablets : 75

Prescribing where Tessa Jowell Gp Surgery is lower than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score
Co-cyprindiol (Cyprote acetate/ethinylestradiol)	6	Oral preparations for acne	79	0.08	0.97	0.13	-6.65
Dianette tablets (Bayer) : 2 Co-cyprindiol 2000microgram/35microgram tablets : 4
Spironolactone	81	Potassium-sparing diuretics and aldosterone antagonists	358	0.23	0.72	0.14	-3.59
Spironolactone 25mg tablets : 66 Spironolactone 50mg/5ml oral suspension : 2 Spironolactone 50mg tablets : 9 Spironolactone 100mg tablets : 4
Sodium cromoglicate	23	Other anti-inflammatory preparations	110	0.21	0.67	0.18	-2.51
Sodium cromoglicate 2% eye drops : 13 Opticrom Allergy 2% eye drops : 10
Urea hydrogen peroxide	0	Removal of ear wax and other substances	2	0.00	0.83	0.34	-2.47

Finasteride	107	Male sex hormones and antagonists	194	0.55	0.82	0.12	-2.32
Finasteride 5mg tablets : 107