Static outliers for Vine Medical Group

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 Vine Medical Group is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Tolnaftate 1 Antifungal preparations 201 0.00 0.00 0.00 5.15
Magnesium hydroxide 6 Antacids and simeticone 9 0.67 0.03 0.14 4.47
Diphtheria 13 Vaccines and antisera 13 1.00 0.15 0.22 3.87
Denosumab 91 Bisphosphonates and other drugs 1112 0.08 0.01 0.02 3.82
Acipimox 5 Lipid-regulating drugs 11693 0.00 0.00 0.00 3.33

Prescribing where Vine Medical Group is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Betamethasone valerate 224 Topical corticosteroids 1552 0.14 0.28 0.07 -2.01
Theophylline 31 Theophylline 89 0.35 0.83 0.25 -1.96
Oral rehydration salts 10 Oral sodium and water 74 0.14 0.68 0.31 -1.77
Zinc sulfate monohydrate 2 Zinc 26 0.08 0.73 0.40 -1.65
Fluticasone propionate (Inhalation) 213 Corticosteroids (respiratory) 4225 0.05 0.18 0.08 -1.57
Seretide 50 Evohaler : 38
Seretide 125 Evohaler : 49
Seretide 250 Evohaler : 34
Fluticasone 250mcg/dose / Salmeterol 25mcg/dose inh CFC free : 2
Flixotide 250micrograms/dose Accuhaler : 2
Flutiform 250micrograms/dose / 10micrograms/dose inhaler : 2
Fluticasone propionate 100micrograms/dose dry powder inhaler : 1
Flixotide 100micrograms/dose Accuhaler : 1
Flixotide 125micrograms/dose Evohaler : 1
Sirdupla 25micrograms/dose / 250micrograms/dose inhaler : 1
AirFluSal Forspiro 50microg / 500microg/dose dry pdr inh : 1
Seretide 100 Accuhaler : 14
Fluticasone 50micrograms/dose inhaler CFC free : 4
Fluticasone propionate 100microg/Salmeterol 50microg/dose : 3
Fluticasone 125micrograms/dose inhaler CFC free : 3
Fluticasone 250micrograms/dose inhaler CFC free : 3
Fluticasone 125microg/Formoterol 5microg/dose BA inh CFCfree : 3
Sirdupla 25micrograms/dose / 125micrograms/dose inhaler : 3
AirFluSal 25micrograms/dose / 250micrograms/dose inhaler : 3
Flixotide 50micrograms/dose Evohaler : 7
Flutiform 50micrograms/dose / 5micrograms/dose inhaler : 7
Seretide 250 Accuhaler : 16
Flutiform 125micrograms/dose / 5micrograms/dose inhaler : 15