Static outliers for Denton Village 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 Denton Village Surgery is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sulindac 6 Non-steroidal anti-inflammatory drugs 414 0.01 0.00 0.00 16.15
Ergocalciferol 155 Vitamin D 1911 0.08 0.00 0.01 12.41
Triptorelin acetate 26 Prostate cancer and gonadorelin analogues 55 0.47 0.02 0.06 7.60
Lidocaine 2 Topical local anaesthetics and antipruritics 2 1.00 0.08 0.15 6.17
Perampanel 24 Control of epilepsy 1241 0.02 0.00 0.00 4.75

Prescribing where Denton Village Surgery is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ispaghula husk 134 Bulk-forming laxatives 216 0.62 0.96 0.07 -4.62
Diazepam 40 Anxiolytics 172 0.23 0.75 0.14 -3.84
Colecalciferol 1731 Vitamin D 1911 0.91 0.96 0.02 -2.32
Colecalciferol 800unit capsules : 651
Colecalciferol 1,000unit tablets : 54
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 88
Accrete D3 tablets : 39
Adcal-D3 chewable tablets tutti frutti : 296
Adcal-D3 750mg/200unit caplets : 206
Calceos 500mg/400unit chewable tablets : 39
Fultium-D3 800unit capsules : 142
Evacal D3 1500mg/400unit chewable tablets : 58
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 2
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 1
Colecalciferol 4,000unit tablets : 1
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 23
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 4
Colecalciferol 3,200unit capsules : 27
InVita D3 50,000unit capsules : 7
InVita D3 25,000units/1ml oral solution : 11
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 25
Adcal-D3 Lemon chewable tablets : 25
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 6
Calcichew D3 Forte chewable tablets : 6
Colecalciferol 800unit tablets : 5
Colecalciferol 400unit tablets : 5
Calfovit D3 oral powder sachets : 5
Desunin 800unit tablets : 5
Salicylic acid 0 Preparations for warts and calluses 2 0.00 0.69 0.31 -2.20
Methylprednisolone acetate 0 Local corticosteroid injections 2 0.00 0.73 0.39 -1.87