Static outliers for Eden Court Medical Practice

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 Eden Court Medical Practice is higher than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Nimodipine☰	3	Calcium-channel blockers	2496	0.00	0.00	0.00	12.65
Nimodipine 30mg tablets : 3
Cetrimide☰	1	Shampoos and some other scalp preparations	226	0.00	0.00	0.00	6.82
Ceanel Concentrate shampoo : 1
Bempedoic acid☰	3	Lipid-regulating drugs	5264	0.00	0.00	0.00	6.20
Bempedoic acid 180mg tablets : 3
Chlorhex hydrochloride☰	1	Preparations for minor cuts and abrasions	2	0.50	0.01	0.08	6.12
Chlorhexidine hydrochloride 0.5% cream : 1
Combined ethinylestradiol 35mcg☰	38	Combined hormonal contraceptives	149	0.26	0.06	0.04	5.30
Cilique 250microgram/35microgram tablets : 36 Norimin 1mg/35microgram tablets : 1 Lizinna 250microgram/35microgram tablets : 1

Prescribing where Eden Court Medical Practice is lower than most

BNF Chemical	Chemical Items	BNF Subparagraph	Subparagraph Items	Ratio	Mean	std	Z_Score	Plots
Combined ethinylestradiol 30mcg☰	84	Combined hormonal contraceptives	149	0.56	0.81	0.07	-3.33
Microgynon 30 tablets : 61 Femodene tablets : 2 Microgynon 30 ED tablets : 1 Rigevidon tablets : 1 Gedarel 30microgram/150microgram tablets : 1 Cimizt 30microgram/150microgram tablets : 1 Marvelon tablets : 7 Yasmin tablets : 10
Carbimazole☰	32	Antithyroid drugs	48	0.67	0.93	0.11	-2.49
Carbimazole 15mg tablets : 1 Carbimazole 5mg tablets : 21 Carbimazole 20mg tablets : 10
Famotidine☰	1	H2-Receptor antagonists	5	0.20	0.78	0.23	-2.48
Famotidine 20mg tablets : 1
Donepezil hydrochloride☰	4	Drugs for dementia	89	0.04	0.49	0.19	-2.41
Donepezil 5mg tablets : 1 Donepezil 10mg tablets : 3
Glycopyrronium bromide☰	0	Antimuscarinic drugs	5	0.00	0.82	0.36	-2.30