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

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Atomoxetine hydrochloride 22 CNS Stimulants and drugs used for ADHD 22 1.00 0.08 0.12 7.97
Hepatitis A 37 Vaccines and antisera 51 0.73 0.05 0.11 6.15
Oestrogens conjugated with progestogen 7 Oestrogens and Hormone Replacement Therapy 49 0.14 0.01 0.02 5.91
Calcium gluconate 2 Calcium supplements 7 0.29 0.00 0.05 5.87
Selegiline hydrochloride 6 Dopaminergic drugs used in parkinsonism 71 0.08 0.00 0.01 5.51

Prescribing where Soho Road Primary Care Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ivermectin 0 Topical preparation for rosacea 2 0.00 0.88 0.24 -3.72
Methylphenidate hydrochloride 0 CNS Stimulants and drugs used for ADHD 22 0.00 0.65 0.21 -3.15
Aciclovir 10 Herpes simplex and varicella-zoster 13 0.77 0.95 0.07 -2.69
Colecalciferol 763 Vitamin D 847 0.90 0.96 0.02 -2.52
Accrete D3 tablets : 142
Adcal-D3 chewable tablets tutti frutti : 121
Adcal-D3 750mg/200unit caplets : 81
Fultium-D3 20,000unit capsules : 53
InVita D3 25,000units/1ml oral solution : 31
InVita D3 50,000units/1ml oral solution : 104
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 2
Colecalciferol 25,000units/1ml soln ud amp sugar free : 2
Calcichew D3 Forte chewable tablets : 2
Fultium-D3 3,200unit capsules : 2
InVita D3 25,000unit capsules : 2
TheiCal-D3 1000mg/880unit chewable tablets : 2
Stexerol-D3 1,000unit tablets : 2
Strivit-D3 800unit capsules : 2
Colecalciferol 3,000unit tablets : 1
Colecalciferol 2,000units/ml oral drops sugar free : 1
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 1
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 1
Colecalciferol 4,000unit tablets : 1
Colecalciferol 400units/ml oral drops sugar free : 1
Valupak Vitamin D3 1,000unit tablets : 1
SunVit-D3 10,000unit tablets : 1
Aciferol D3 2,000units/ml liquid : 1
InVita D3 2,400units/ml oral drops : 1
Calceos 500mg/400unit chewable tablets : 9
InVita D3 5,600unit capsules : 9
Colecalciferol 1,000unit tablets : 23
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 23
Calcichew D3 chewable tablets : 4
Bio-Vitamin D3 5,000unit capsules : 4
Fultium-D3 800unit capsules : 13
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 3
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 3
Colecalciferol 2,000unit tablets : 3
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 3
Pro D3 forte 3,000units/ml liquid : 3
Calci-D 1000mg/1,000unit chewable tablets : 7
Colecalciferol 800unit tablets : 21
Colecalciferol 50,000units/1ml soln ud amp sugar free : 6
InVita D3 50,000unit capsules : 6
InVita D3 800unit capsules : 20
Colecalciferol 800unit capsules : 15
Colecalciferol 400unit tablets : 10
Accrete D3 One a Day 1000mg/880unit chewable tablets : 10
Adcal-D3 Lemon chewable tablets : 5
Bio-Vitamin D3 1,000unit capsules : 5
Pizotifen malate 0 Prophylaxis of migraine 13 0.00 0.65 0.26 -2.49