Static outliers for Laurie Pike Health 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 Laurie Pike Health Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Other topical nasal decongestant preparations 1 Topical nasal decongestants 14 0.07 0.0 0.01 12.69
Metformin hydrochloride/pioglitazone 102 Other antidiabetic drugs 1811 0.06 0.0 0.00 12.09
Nateglinide 1 Other antidiabetic drugs 1811 0.00 0.0 0.00 11.40
Wool alcohols 108 Emollients 1149 0.09 0.0 0.01 9.07
Tocofersolan 4 Vitamin E 10 0.40 0.0 0.04 9.07

Prescribing where Laurie Pike Health Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Methylphenidate hydrochloride 4 CNS Stimulants and drugs used for ADHD 24 0.17 0.65 0.21 -2.35
Co-cyprindiol (Cyprote acetate/ethinylestradiol) 2 Oral preparations for acne 3 0.67 0.97 0.13 -2.27
Colecalciferol 1824 Vitamin D 2011 0.91 0.96 0.02 -2.27
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 58
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 349
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 85
Accrete D3 tablets : 144
Adcal-D3 chewable tablets tutti frutti : 128
Adcal-D3 Lemon chewable tablets : 49
Adcal-D3 750mg/200unit caplets : 575
Fultium-D3 20,000unit capsules : 71
InVita D3 50,000units/1ml oral solution : 31
InVita D3 50,000unit capsules : 64
Fultium-D3 3,200unit capsules : 2
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 1
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 10,000units/ml oral solution sugar free : 1
Colecalciferol 2,400units/ml oral drops sugar free : 1
Colecalciferol 50,000units/1ml soln ud amp sugar free : 1
Colecalciferol 5,600unit capsules : 1
Colecalciferol 2,000unit chewable tablets : 1
Colecalciferol 400units/ml oral drops sugar free : 1
Calcichew D3 chewable tablets : 1
Fultium-D3 2,740units/ml oral drops : 1
Thorens 10,000units/ml oral drops : 1
Colecalciferol 50,000unit capsules : 9
Colecalciferol 25,000unit capsules : 4
InVita D3 2,400units/ml oral drops : 4
InVita D3 800unit capsules : 4
Fultium-D3 800unit capsules : 18
Colecalciferol 800unit tablets : 22
Colecalciferol 25,000units/1ml soln ud amp sugar free : 3
SunVit-D3 10,000unit tablets : 3
InVita D3 25,000unit capsules : 3
Colecalciferol 400unit tablets : 7
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 21
Hux D3 20,000unit capsules : 21
Colecalciferol 800unit capsules : 25
Calcichew D3 Forte chewable tablets : 25
Colecalciferol 1,000unit capsules : 6
Colecalciferol 30,000unit capsules : 6
Calceos 500mg/400unit chewable tablets : 6
Calci-D 1000mg/1,000unit chewable tablets : 6
InVita D3 25,000units/1ml oral solution : 15
Colecalciferol 3,200unit capsules : 10
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 10
Colecalciferol 400unit / Calcium carbonate 1.25g tablets : 5
Colecalciferol 20,000unit capsules : 5
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 19
Alfentanil hydrochloride 0 Opioid analgesics 1 0.00 0.82 0.37 -2.21
Budesonide 0 Corticosteroids 9 0.00 0.70 0.34 -2.08