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

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Naphazoline hydrochloride 6 Other anti-inflammatory preparations 173 0.03 0.00 0.00 7.13
Co-proxamol (Dextropropoxyphene hydrochloride/paracetamol) 27 Non-opioid analgesics and compound preparations 3678 0.01 0.00 0.00 6.29
Chlorhexidine gluconate 3 Preparations for minor cuts and abrasions 4 0.75 0.02 0.13 5.71
Demeclocycline hydrochloride 16 Tetracyclines 463 0.03 0.00 0.01 5.22
Haloperidol decanoate 1 Antipsychotic depot injections 1 1.00 0.08 0.22 4.21

Prescribing where Park Road Group Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Pyridostigmine bromide 4 Drugs which enhance neuromuscular transmission 10 0.40 1.00 0.00 -202.11
Terbinafine hydrochloride 47 Other antifungals 51 0.92 0.99 0.03 -2.08
Hydrocortisone 38 Copound haemorrhoidal preparations with corticosteroid 170 0.22 0.58 0.24 -1.49
Tramadol hydrochloride 467 Opioid analgesics 3267 0.14 0.27 0.09 -1.39
Co-codamol (Codeine phosphate/paracetamol) 919 Non-opioid analgesics and compound preparations 3678 0.25 0.45 0.15 -1.31