Static outliers for Newport Medical Group

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 Newport Medical Group is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Pyrazinamide 1 Antituberculosis drugs 4 0.25 0.00 0.01 16.99
Phenylephrine hydrochloride 4 Mydriatics and cycloplegics 18 0.22 0.00 0.02 13.05
Ranitidine hydrochloride 30 H2-Receptor antagonists 34 0.88 0.04 0.12 7.22
Acenocoumarol 8 Oral anticoagulants 357 0.02 0.00 0.00 6.95
Hexetidine 2 Mouth-washes, gargles and dentifrices 5 0.40 0.01 0.06 6.74

Prescribing where Newport Medical Group is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 1021 Vitamin D 1199 0.85 0.96 0.02 -4.51
Colecalciferol 800unit capsules : 33
Accrete D3 tablets : 44
Adcal-D3 chewable tablets tutti frutti : 46
Adcal-D3 750mg/200unit caplets : 104
Fultium-D3 800unit capsules : 36
Hux D3 20,000unit capsules : 123
InVita D3 25,000units/1ml oral solution : 54
InVita D3 50,000units/1ml oral solution : 227
InVita D3 800unit capsules : 36
Calci-D 1000mg/1,000unit chewable tablets : 190
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 2
Colecalciferol 25,000unit capsules : 2
Colecalciferol 400unit tablets : 2
Colecalciferol 3,000unit tablets : 1
Colecalciferol 600unit capsules : 1
Colecalciferol 1,000unit tablets : 1
Colecalciferol 3,200unit capsules : 1
Colecalciferol 2,400units/ml oral drops sugar free : 1
Colecalciferol 2,740units/ml oral drops sugar free : 1
Cacit D3 effervescent granules sachets : 1
Strivit-D3 800unit capsules : 1
Colecalciferol 25,000units/1ml soln ud amp sugar free : 4
Colecalciferol 50,000units/1ml soln ud amp sugar free : 4
InVita D3 50,000unit capsules : 18
Desunin 800unit tablets : 13
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 3
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 17
Calceos 500mg/400unit chewable tablets : 12
Adcal-D3 Lemon chewable tablets : 6
Calcichew D3 chewable tablets : 6
Calcichew D3 Forte chewable tablets : 6
Thorens 10,000units/ml oral drops : 15
Colecalciferol 800unit tablets : 5
InVita D3 25,000unit capsules : 5
Chlorhexidine gluconate 3 Mouth-washes, gargles and dentifrices 5 0.60 0.97 0.11 -3.55
Co-cyprindiol (Cyprote acetate/ethinylestradiol) 2 Oral preparations for acne 4 0.50 0.97 0.13 -3.51
Famotidine 3 H2-Receptor antagonists 34 0.09 0.78 0.23 -2.96
Methylphenidate hydrochloride 1 CNS Stimulants and drugs used for ADHD 8 0.12 0.65 0.21 -2.55