Static outliers for Shipston 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 Shipston Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Adalimumab 5 Rheumatic disease suppressant drugs 408 0.01 0.00 0.00 130.75
Co-triamterzide(Triamterene/hydrochlorothiazide) 1 Potassium sparing diuretics and compounds 22 0.05 0.00 0.00 38.96
Tryptophan 20 Other antidepressant drugs 1718 0.01 0.00 0.00 31.08
Magnesium lactate 7 Magnesium 11 0.64 0.01 0.07 9.39
Ergocalciferol 135 Vitamin D 2242 0.06 0.00 0.01 9.10

Prescribing where Shipston Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Phenoxymethylpenicillin (Penicillin V) 135 Benzylpenicillin and phenoxymethylpenicillin 136 0.99 1.00 0.00 -6.67
Loperamide hydrochloride 151 Antimotility drugs 156 0.97 1.00 0.01 -2.53
Colecalciferol 2027 Vitamin D 2242 0.90 0.96 0.02 -2.39
Colecalciferol 800unit capsules : 94
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 37
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 269
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 44
Adcal-D3 chewable tablets tutti frutti : 255
Adcal-D3 Lemon chewable tablets : 170
Adcal-D3 750mg/200unit caplets : 35
Calcichew D3 chewable tablets : 37
Calcichew D3 Forte chewable tablets : 54
Fultium-D3 800unit capsules : 217
Evacal D3 1500mg/400unit chewable tablets : 672
Colecalciferol 1,000unit capsules : 2
Colecalciferol 10,000units/ml oral solution sugar free : 2
Calceos 500mg/400unit chewable tablets : 2
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 1
Colecalciferol 2,000unit tablets : 1
Colecalciferol 20,000unit capsules : 1
Colecalciferol 50,000unit capsules : 1
BabyD 1,000units/ml oral solution : 1
Accrete D3 tablets : 1
Valupak Vitamin D3 1,000unit tablets : 1
DLux 400 oral spray : 1
InVita D3 2,400units/ml oral drops : 1
InVita D3 50,000units/1ml oral solution : 1
Colecalciferol 4,000unit tablets : 4
InVita D3 25,000units/1ml oral solution : 4
Colecalciferol 400unit tablets : 8
Cacit D3 effervescent granules sachets : 3
Hux D3 20,000unit capsules : 26
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 7
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 7
Calci-D 1000mg/1,000unit chewable tablets : 7
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 11
Colecalciferol 400unit capsules : 25
Colecalciferol 1,000unit tablets : 20
Colecalciferol 2,740units/ml oral drops sugar free : 5
Mercaptopurine 0 Antimetabolites 5 0.00 0.80 0.35 -2.31
Famotidine 37 H2-Receptor antagonists 110 0.34 0.78 0.23 -1.90