Static outliers for The Park 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 The Park Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Olmesartan medoxomil/hydrochlorothiazide 16 Angiotensin-II receptor antagonists 510 0.03 0.00 0.00 11.71
Mefenamic acid 22 Non-steroidal anti-inflammatory drugs 98 0.22 0.03 0.02 8.08
Cetylpyridinium chloride 3 Mouth-washes, gargles and dentifrices 18 0.17 0.00 0.03 5.91
Sodium clodronate 3 Bisphosphonates and other drugs 99 0.03 0.00 0.01 5.75
Prasugrel 28 Antiplatelet drugs 1075 0.03 0.00 0.00 4.94

Prescribing where The Park Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Folic acid 76 Drugs used in megaloblastic anaemias 339 0.22 0.70 0.16 -3.00
Colecalciferol 844 Vitamin D 941 0.90 0.96 0.02 -2.68
Adcal-D3 chewable tablets tutti frutti : 32
Adcal-D3 750mg/200unit caplets : 131
Hux D3 20,000unit capsules : 147
Desunin 800unit tablets : 101
Evacal D3 1500mg/400unit chewable tablets : 124
InVita D3 800unit capsules : 148
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 2
SunVit-D3 3,000units/ml oral solution : 2
Colecalciferol 800unit capsules : 1
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 1
Colecalciferol 10,000unit tablets : 1
Colecalciferol 3,200unit capsules : 1
Colecalciferol 2,400units/ml oral drops sugar free : 1
Colecalciferol 20,000unit capsules : 1
Colecalciferol 2,740units/ml oral drops sugar free : 1
Colecalciferol 400unit tablets : 1
Fultium-D3 3,200unit capsules : 1
InVita D3 25,000units/1ml oral solution : 1
InVita D3 50,000unit capsules : 1
Calci-D 1000mg/1,000unit chewable tablets : 1
Colecalciferol 800unit tablets : 14
Pro D3 forte 3,000units/ml liquid : 14
Adcal-D3 Lemon chewable tablets : 4
InVita D3 2,400units/ml oral drops : 4
Pro D3 2,000units/ml liquid drops : 3
Pro D3 800unit Vegan capsules : 3
Valupak Vitamin D3 1,000unit tablets : 3
Calcichew D3 Forte chewable tablets : 3
Fultium-D3 800unit capsules : 21
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 16
Calceos 500mg/400unit chewable tablets : 11
TheiCal-D3 1000mg/880unit chewable tablets : 11
Pro D3 1,000unit capsules : 6
SunVit-D3 10,000unit capsules : 6
InVita D3 400unit capsules : 6
Pro D3 10,000unit capsules : 10
Colecalciferol 2,000units/ml oral drops sugar free : 5
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 5
Water for injection 1 Electrolytes and water 8 0.12 0.82 0.26 -2.66
Midazolam hydrochloride 0 Drugs used in status epilepticus 1 0.00 0.79 0.30 -2.62
Insulin aspart 62 Short-acting insulins 119 0.52 0.79 0.12 -2.31