Static outliers for The Saxon Spires 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 The Saxon Spires Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sucralfate 2 Soothing haemorrhoidal preparations 10 0.20 0.00 0.02 10.47
Sodium oxybate 7 Hypnotics 619 0.01 0.00 0.00 9.98
Dabigatran etexilate 336 Oral anticoagulants 2550 0.13 0.02 0.02 5.61
Other magnesium preparations 6 Magnesium 19 0.32 0.01 0.07 4.21
Aclidinium bromide 134 Antimuscarinic bronchodilators 406 0.33 0.04 0.07 4.17

Prescribing where The Saxon Spires Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Potassium citrate 0 Drugs used in urological pain 1 0.00 0.93 0.24 -3.87
Procyclidine hydrochloride 12 Antimuscarinic drugs used in parkinsonism 44 0.27 0.84 0.21 -2.73
Loperamide hydrochloride 143 Antimotility drugs 148 0.97 1.00 0.01 -2.67
Salicylic acid 0 Preparations for warts and calluses 20 0.00 0.69 0.31 -2.20
Colecalciferol 1625 Vitamin D 1787 0.91 0.96 0.02 -2.17
Colecalciferol 800unit capsules : 31
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 71
Adcal-D3 chewable tablets tutti frutti : 278
Adcal-D3 750mg/200unit caplets : 67
Fultium-D3 800unit capsules : 95
Evacal D3 1500mg/400unit chewable tablets : 92
InVita D3 25,000units/1ml oral solution : 40
TheiCal-D3 1000mg/880unit chewable tablets : 737
Colecalciferol 800unit tablets : 2
Colecalciferol 20,000unit capsules : 2
Colecalciferol 400unit tablets : 2
Colecalciferol 50,000unit capsules : 2
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 1
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 1
Colecalciferol 2,400units/ml oral drops sugar free : 1
Colecalciferol 50,000units/1ml soln ud amp sugar free : 1
Aciferol D3 10,000unit tablets : 1
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 14
Calcichew D3 chewable tablets : 9
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 4
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 4
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 4
Calceos 500mg/400unit chewable tablets : 4
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 4
Fultium-D3 3,200unit capsules : 18
Colecalciferol 400unit capsules : 13
Calcichew D3 Forte chewable tablets : 13
Adcal-D3 Lemon chewable tablets : 22
Colecalciferol 1,000unit capsules : 3
Natecal D3 600mg/400unit chewable tablets : 3
SunVit-D3 400unit capsules : 3
Accrete D3 tablets : 17
InVita D3 50,000unit capsules : 17
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 7
Colecalciferol 3,000unit tablets : 6
InVita D3 25,000unit capsules : 6
Colecalciferol 25,000units/1ml soln ud amp sugar free : 20
Calci-D 1000mg/1,000unit chewable tablets : 10