Static outliers for Great Bridge P/Ship For Health

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 Great Bridge P/Ship For Health is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Bempedoic acid 4 Lipid-regulating drugs 6121 0.00 0.00 0.00 7.13
Co-danthrusate (Dantron/docusate sodium) 1 Stimulant laxatives 596 0.00 0.00 0.00 6.30
Gentamicin sulfate 16 Antibacterials 46 0.35 0.03 0.06 5.45
Ephedrine hydrochloride 4 Systemic nasal decongestants 4 1.00 0.04 0.18 5.25
Magnesium citrate 4 Magnesium 4 1.00 0.07 0.21 4.47

Prescribing where Great Bridge P/Ship For Health is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Pseudoephedrine hydrochloride 0 Systemic nasal decongestants 4 0.00 0.96 0.18 -5.25
Mercaptopurine 0 Antimetabolites 5 0.00 0.80 0.35 -2.31
Memantine hydrochloride 0 Drugs for dementia 76 0.00 0.37 0.18 -2.09
Colecalciferol 1247 Vitamin D 1365 0.91 0.96 0.02 -2.00
Colecalciferol 800unit capsules : 34
Colecalciferol 1,000unit capsules : 49
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 97
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 34
Adcal-D3 chewable tablets tutti frutti : 234
Adcal-D3 Lemon chewable tablets : 41
Adcal-D3 750mg/200unit caplets : 400
Fultium-D3 800unit capsules : 49
InVita D3 50,000unit capsules : 43
Colecalciferol 20,000unit tablets : 2
Colecalciferol 25,000unit tablets : 2
InVita D3 400unit capsules : 2
TheiCal-D3 1000mg/880unit chewable tablets : 2
Strivit-D3 800unit capsules : 2
Colecalciferol 600unit capsules : 1
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 1
Colecalciferol 2,000units/ml oral drops sugar free : 1
Colecalciferol 5,000unit tablets : 1
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 1
Colecalciferol 25,000unit capsules : 1
Colecalciferol 400units/ml oral drops sugar free : 1
Pro D3 400unit capsules : 1
SunVit-D3 10,000unit tablets : 1
Stexerol-D3 1,000unit tablets : 1
Thorens 10,000units/ml oral drops : 1
Urgent-D 2,000unit chewable tablets : 1
Colecalciferol 800unit tablets : 9
Colecalciferol 50,000unit tablets : 9
InVita D3 25,000units/1ml oral solution : 9
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 4
Colecalciferol 50,000units/1ml soln ud amp sugar free : 4
Colecalciferol 50,000unit capsules : 4
Calci-D 1000mg/1,000unit chewable tablets : 4
Colecalciferol 1,000unit tablets : 8
Colecalciferol 30,000unit capsules : 8
Fultium-D3 3,200unit capsules : 8
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 3
Hux D3 20,000unit capsules : 3
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 17
Calcichew D3 chewable tablets : 12
Fultium-D3 20,000unit capsules : 12
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 7
InVita D3 50,000units/1ml oral solution : 7
Colecalciferol 3,200unit capsules : 21
Accrete D3 tablets : 16
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 16
Colecalciferol 25,000units/1ml soln ud amp sugar free : 11
Desunin 800unit tablets : 11
InVita D3 800unit capsules : 6
Calceos 500mg/400unit chewable tablets : 10
Calcichew D3 Forte chewable tablets : 10
Colecalciferol 3,000unit tablets : 5
Calfovit D3 oral powder sachets : 5
InVita D3 25,000unit capsules : 5
Water for injection 3 Electrolytes and water 10 0.30 0.82 0.26 -1.99