Static outliers for Raydocs Newtown

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 Raydocs Newtown is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Nicotine bitartrate 5 Nicotine dependence 17 0.29 0.00 0.03 11.15
Nabumetone 27 Non-steroidal anti-inflammatory drugs 615 0.04 0.00 0.01 8.20
Griseofulvin 9 Other antifungals 41 0.22 0.01 0.03 6.19
Labetalol hydrochloride 68 Beta-adrenoceptor blocking drugs 2741 0.02 0.00 0.00 4.80
Prednisolone sodium phosphate 2 Corticosteroids 2 1.00 0.09 0.20 4.57

Prescribing where Raydocs Newtown is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Terbinafine hydrochloride 32 Other antifungals 41 0.78 0.99 0.03 -6.19
Colecalciferol 2248 Vitamin D 2524 0.89 0.96 0.02 -2.93
Colecalciferol 800unit capsules : 77
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 29
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 105
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 119
Colecalciferol 800unit tablets : 46
Colecalciferol 50,000unit capsules : 52
Accrete D3 tablets : 154
Adcal-D3 chewable tablets tutti frutti : 178
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 32
Adcal-D3 750mg/200unit caplets : 1027
InVita D3 50,000units/1ml oral solution : 54
InVita D3 50,000unit capsules : 70
Colecalciferol 1,000unit capsules : 2
Colecalciferol 2,000unit orodispersible tablets sugar free : 2
Colecalciferol 25,000units/1ml soln ud amp sugar free : 2
Colecalciferol 10,000units/ml oral drops sugar free : 2
Pro D3 2,000units/ml liquid : 2
InVita D3 5,600unit capsules : 2
Colecalciferol 3,000unit tablets : 1
Colecalciferol 50,000unit tablets : 1
Colecalciferol 3,200unit capsules : 1
Colecalciferol 400units/ml oral drops sugar free : 1
Pro D3 20,000unit capsules : 1
Accrete D3 One a Day 1000mg/880unit chewable tablets : 1
Fultium-D3 2,740units/ml oral drops : 1
Pro D3 forte 3,000units/ml liquid : 1
InVita D3 2,400units/ml oral drops : 1
Colecalciferol 1,000unit tablets : 14
Stexerol-D3 1,000unit tablets : 14
Calcichew D3 chewable tablets : 9
Hux D3 20,000unit capsules : 23
Colecalciferol 20,000unit tablets : 4
Colecalciferol 50,000units/1ml soln ud amp sugar free : 4
InVita D3 25,000unit capsules : 4
Thorens 10,000units/ml oral drops : 4
Colecalciferol 400unit tablets : 8
Adcal-D3 Lemon chewable tablets : 8
Colecalciferol 400unit capsules : 22
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 3
Colecalciferol 25,000unit capsules : 3
Fultium-D3 3,200unit capsules : 3
Fultium-D3 20,000unit capsules : 3
ColeDose D3 25,000unit capsules : 3
Calci-D 1000mg/1,000unit chewable tablets : 12
Calceos 500mg/400unit chewable tablets : 26
Colecalciferol 2,000units/ml oral drops sugar free : 7
Colecalciferol 5,600unit capsules : 7
Pro D3 2,000units/ml liquid drops : 7
Fultium-D3 800unit capsules : 7
ColeDose D3 50,000unit capsules : 7
Calcichew D3 Forte chewable tablets : 11
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 25
InVita D3 25,000units/1ml oral solution : 25
TheiCal-D3 1000mg/880unit chewable tablets : 6
Colecalciferol 10,000unit capsules : 5
Pro D3 10,000unit capsules : 5
Evacal D3 1500mg/400unit chewable tablets : 5
Memantine hydrochloride 0 Drugs for dementia 48 0.00 0.37 0.18 -2.09
Budesonide 0 Corticosteroids 2 0.00 0.70 0.34 -2.08
Lithium carbonate 15 Drugs used for mania and hypomania 207 0.07 0.61 0.28 -1.93