Static outliers for Bideford 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 Bideford Medical Centre is higher than most
| BNF Chemical | Chemical Items | BNF Subparagraph | Subparagraph Items | Ratio | Mean | std | Z_Score | Plots |
|---|---|---|---|---|---|---|---|---|
| Heparin sodium | 4 | Parenteral anticoagulants | 17 | 0.24 | 0.00 | 0.01 | 38.05 |  |
| Cetrimide | 1 | Shampoos and some other scalp preparations | 114 | 0.01 | 0.00 | 0.00 | 13.57 |  |
| Magnesium trisilicate | 1 | Antacids and simeticone | 1 | 1.00 | 0.03 | 0.14 | 7.11 |  |
| Diltiazem hydrochloride | 553 | Calcium-channel blockers | 3126 | 0.18 | 0.05 | 0.03 | 4.70 |  |
Adizem-XL 240mg capsules : 61 Zemtard 300 XL capsules : 64 Zemtard 120 XL capsules : 148 Zemtard 180 XL capsules : 63 Zemtard 240 XL capsules : 68 Adizem-SR 180mg capsules : 2 Adizem-XL 200mg capsules : 2 Tildiem Retard 120mg tablets : 14 Tildiem Retard 90mg tablets : 8 Adizem-SR 120mg capsules : 3 Tildiem 60mg modified-release tablets : 26 Adizem-XL 180mg capsules : 26 Tildiem LA 300 capsules : 7 Tildiem LA 200 capsules : 11 Adizem-XL 120mg capsules : 25 Adizem-SR 90mg capsules : 10 Adizem-XL 300mg capsules : 10 Viazem XL 180mg capsules : 5 | ||||||||
| Nebivolol | 312 | Beta-adrenoceptor blocking drugs | 3662 | 0.09 | 0.01 | 0.02 | 4.07 |  |
Prescribing where Bideford Medical Centre is lower than most
| BNF Chemical | Chemical Items | BNF Subparagraph | Subparagraph Items | Ratio | Mean | std | Z_Score | Plots |
|---|---|---|---|---|---|---|---|---|
| Pseudoephedrine hydrochloride | 1 | Systemic nasal decongestants | 3 | 0.33 | 0.96 | 0.18 | -3.43 |  |
| Senna | 246 | Stimulant laxatives | 1112 | 0.22 | 0.55 | 0.14 | -2.38 |  |
| Glycopyrronium bromide | 1 | Antimuscarinic drugs | 36 | 0.03 | 0.82 | 0.36 | -2.22 |  |
| Fexofenadine hydrochloride | 199 | Antihistamines | 1614 | 0.12 | 0.36 | 0.12 | -1.92 |  |
| Oral rehydration salts | 6 | Oral sodium and water | 38 | 0.16 | 0.68 | 0.31 | -1.69 |  |