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

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Hydrocort sodiumphos 5 Antibacterials 31 0.16 0.01 0.03 4.54
Other calcium supplement preparations 3 Calcium supplements 5 0.60 0.04 0.12 4.47
Trifluoperazine 13 Antipsychotic drugs 359 0.04 0.00 0.01 4.27
Loteprednol etabonate 15 Corticosteroids 60 0.25 0.02 0.05 4.17
Alkyl sulfate 2 Shampoos and some other scalp preparations 69 0.03 0.00 0.01 3.72

Prescribing where The Wand Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Calcium carbonate 2 Calcium supplements 5 0.40 0.95 0.13 -4.14
Colecalciferol 632 Vitamin D 714 0.89 0.96 0.02 -3.15
Adcal-D3 chewable tablets tutti frutti : 44
Adcal-D3 750mg/200unit caplets : 79
Fultium-D3 800unit capsules : 59
Desunin 800unit tablets : 139
Evacal D3 1500mg/400unit chewable tablets : 108
InVita D3 25,000units/1ml oral solution : 42
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 2
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 2
Colecalciferol 400units/ml oral drops sugar free : 2
Colecalciferol 10,000units/ml oral solution sugar free : 1
Colecalciferol 50,000units/1ml soln ud amp sugar free : 1
Colecalciferol 400unit tablets : 1
Desunin 4,000unit tablets : 1
Strivit-D3 800unit capsules : 1
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 14
Colecalciferol 3,200unit capsules : 9
Accrete D3 tablets : 9
SunVit-D3 20,000unit tablets : 9
InVita D3 25,000unit capsules : 4
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 18
InVita D3 50,000units/1ml oral solution : 18
InVita D3 800unit capsules : 18
Calcichew D3 Forte chewable tablets : 13
Colecalciferol 800unit capsules : 3
Colecalciferol 1,000unit tablets : 3
Colecalciferol 25,000units/1ml soln ud amp sugar free : 3
Adcal-D3 Lemon chewable tablets : 3
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 3
Colecalciferol 800unit tablets : 12
InVita D3 50,000unit capsules : 6
Calcichew D3 chewable tablets : 5
Donepezil hydrochloride 0 Drugs for dementia 1 0.00 0.49 0.19 -2.65
Methotrexate 10 Rheumatic disease suppressant drugs 49 0.20 0.58 0.15 -2.43
Medroxyprogesterone acetate 18 Parenteral progestogen-only contraceptives 35 0.51 0.88 0.16 -2.26