Static outliers for Churchill 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 Churchill Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Oxitriptan 2 Other antidepressant drugs 1555 0.00 0.00 0.00 96.81
Alendronic acid/colecalciferol 24 Bisphosphonates and other drugs 349 0.07 0.00 0.01 12.96
Cholera 5 Vaccines and antisera 83 0.06 0.00 0.01 9.71
Wool alcohols 42 Emollients 489 0.09 0.00 0.01 8.26
Magnesium trisilicate 2 Antacids and simeticone 2 1.00 0.03 0.14 7.11

Prescribing where Churchill Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 1516 Vitamin D 1732 0.88 0.96 0.02 -3.55
Colecalciferol 800unit capsules : 252
Colecalciferol 1,000unit tablets : 99
Colecalciferol 1,000unit capsules : 124
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 211
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 278
Colecalciferol 800unit tablets : 37
Adcal-D3 chewable tablets tutti frutti : 65
Adcal-D3 Lemon chewable tablets : 33
Calcichew D3 chewable tablets : 29
Calcichew D3 Forte chewable tablets : 109
TheiCal-D3 1000mg/880unit chewable tablets : 81
Colecalciferol 200units/drop oral drops sugar free : 2
Colecalciferol 4,000unit tablets : 2
Calceos 500mg/400unit chewable tablets : 2
Natecal D3 600mg/400unit chewable tablets : 2
Colecalciferol 10,000units/ml oral solution sugar free : 1
Accrete D3 tablets : 1
SunVit-D3 10,000unit capsules : 1
Plenachol D3 40,000unit capsules : 1
Colecalciferol 400unit tablets : 14
Colecalciferol 400unit capsules : 4
Colecalciferol 200units/drop oral drops : 4
Fultium-D3 800unit capsules : 4
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 27
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 8
Strivit-D3 20,000unit capsules : 8
Adcal-D3 750mg/200unit caplets : 22
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 3
Colecalciferol 2,000units/ml oral drops sugar free : 3
Colecalciferol 20,000unit tablets : 3
Colecalciferol 50,000unit capsules : 3
Colecalciferol 400unit chewable tablets : 3
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 12
Colecalciferol 2,000unit tablets : 11
Colecalciferol 20,000unit capsules : 25
Cacit D3 effervescent granules sachets : 6
Plenachol D3 20,000unit capsules : 6
Colecalciferol 40,000unit capsules : 10
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 5
Colecalciferol 2,500unit capsules : 5
Medroxyprogesterone acetate 5 Parenteral progestogen-only contraceptives 15 0.33 0.88 0.16 -3.37
Zinc oxide 0 Soothing haemorrhoidal preparations 3 0.00 0.77 0.27 -2.89
Coal tar 18 Shampoos and some other scalp preparations 132 0.14 0.41 0.16 -1.71
Procyclidine hydrochloride 54 Antimuscarinic drugs used in parkinsonism 102 0.53 0.84 0.21 -1.51