Static outliers for Finch Road Primary Care 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 Finch Road Primary Care Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Clozapine 12 Antipsychotic drugs 184 0.07 0.00 0.00 40.38
Penicillamine 6 Rheumatic disease suppressant drugs 29 0.21 0.00 0.01 23.17
Alkyl sulfate 11 Shampoos and some other scalp preparations 89 0.12 0.00 0.01 16.62
Ergocalciferol 53 Vitamin D 748 0.07 0.00 0.01 10.79
Losartan potassium with diuretic 47 Angiotensin-II receptor antagonists 381 0.12 0.01 0.02 6.95

Prescribing where Finch Road Primary Care Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Macrogol 3350 80 Osmotic laxatives 205 0.39 0.70 0.10 -3.23
Water for injection 0 Electrolytes and water 8 0.00 0.82 0.26 -3.14
Colecalciferol 669 Vitamin D 748 0.89 0.96 0.02 -2.78
Pro D3 2,000units/ml liquid : 37
Accrete D3 tablets : 184
Adcal-D3 750mg/200unit caplets : 176
InVita D3 25,000unit capsules : 131
Pro D3 1,000unit capsules : 2
Pro D3 2,000units/ml Vegan liquid drops : 2
Pro D3 2,000units/ml Vegan liquid : 2
Calcichew D3 Forte chewable tablets : 2
Colecalciferol 2,000units/ml oral drops sugar free : 1
Hux D3 20,000unit capsules : 1
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 4
Pro D3 800unit capsules : 4
SunVit-D3 800unit capsules : 4
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 18
Adcal-D3 chewable tablets tutti frutti : 18
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 8
Pro D3 2,000units/ml liquid drops : 3
Valupak Vitamin D3 1,000unit tablets : 3
Calcichew D3 chewable tablets : 3
Pro D3 400unit capsules : 17
Fultium-D3 800unit capsules : 17
Colecalciferol 800unit capsules : 6
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 6
Evacal D3 1500mg/400unit chewable tablets : 10
Desunin 800unit tablets : 5
InVita D3 800unit capsules : 5
Donepezil hydrochloride 0 Drugs for dementia 11 0.00 0.49 0.19 -2.65
Clopidogrel 101 Antiplatelet drugs 633 0.16 0.32 0.06 -2.58