Static outliers for The Gables Medicentre

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 Gables Medicentre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Nimodipine 5 Calcium-channel blockers 4351 0.00 0.00 0.00 12.09
Ergocalciferol 179 Vitamin D 2385 0.08 0.00 0.01 11.45
Other zinc preparations 1 Zinc 1 1.00 0.03 0.15 6.31
Erythromycin stearate 5 Macrolides 159 0.03 0.00 0.01 3.23
Lidocaine hydrochloride 20 Soothing haemorrhoidal preparations 37 0.54 0.06 0.15 3.19

Prescribing where The Gables Medicentre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 2132 Vitamin D 2385 0.89 0.96 0.02 -2.80
Colecalciferol 800unit capsules : 312
Colecalciferol 400unit capsules : 66
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 234
Accrete D3 tablets : 67
Adcal-D3 chewable tablets tutti frutti : 242
Adcal-D3 Lemon chewable tablets : 43
Adcal-D3 750mg/200unit caplets : 52
Calcichew D3 chewable tablets : 40
Calcichew D3 Forte chewable tablets : 148
Fultium-D3 800unit capsules : 612
Evacal D3 1500mg/400unit chewable tablets : 123
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 2
SunVit-D3 400unit Vegan tablets : 2
InVita D3 25,000units/1ml oral solution : 2
Colecalciferol 600unit capsules : 1
Colecalciferol 50,000units/1ml soln ud amp sugar free : 1
Colecalciferol 50,000unit capsules : 1
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 14
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 9
Colecalciferol 1,000unit capsules : 4
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 4
Fultium-D3 2,740units/ml oral drops : 4
Colecalciferol 20,000unit tablets : 8
Calci-D 1000mg/1,000unit chewable tablets : 22
Colecalciferol 2,740units/ml oral drops sugar free : 3
Hux D3 20,000unit capsules : 3
Desunin 800unit tablets : 3
HealthAid Vitamin D3 200units/drop oral drops : 3
Colecalciferol 1,000unit tablets : 12
Colecalciferol 400unit tablets : 7
InVita D3 50,000units/1ml oral solution : 16
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 6
Colecalciferol 2,000unit tablets : 6
Colecalciferol 800unit tablets : 15
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 10
Calceos 500mg/400unit chewable tablets : 10
Natecal D3 600mg/400unit chewable tablets : 10
Colecalciferol 50,000unit tablets : 5
Colecalciferol 3,200unit capsules : 5
InVita D3 800unit capsules : 5
Macrogol 3350 347 Osmotic laxatives 682 0.51 0.70 0.10 -2.01
Estradiol 10 Preparations for vaginal/vulval changes 66 0.15 0.55 0.21 -1.86
Zinc sulfate monohydrate 0 Zinc 1 0.00 0.73 0.40 -1.84
Lithium carbonate 6 Drugs used for mania and hypomania 59 0.10 0.61 0.28 -1.82