Static outliers for Broadway Medical 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 Broadway Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Vitamin B and C injection 100 Thiamine hydrochloride (B1) 818 0.12 0.00 0.00 328.30
Chlordiazepoxide hydrochloride 106 Anxiolytics 305 0.35 0.01 0.02 21.98
Gluten free/wheat free grains/flours 8 Foods for special diets 104 0.08 0.00 0.01 13.37
Bempedoic acid/Ezetimibe 1 Lipid-regulating drugs 2102 0.00 0.00 0.00 8.49
Safinamide 10 Dopaminergic drugs used in parkinsonism 96 0.10 0.00 0.01 6.90

Prescribing where Broadway Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Thiamine hydrochloride 718 Thiamine hydrochloride (B1) 818 0.88 1.00 0.00 -328.30
Colecalciferol 738 Vitamin D 892 0.83 0.96 0.02 -5.48
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 43
Adcal-D3 chewable tablets tutti frutti : 169
Adcal-D3 750mg/200unit caplets : 36
Calcichew D3 chewable tablets : 51
Desunin 800unit tablets : 195
Colecalciferol 10,000units/ml oral drops sugar free : 2
Hux D3 20,000unit capsules : 2
Colecalciferol 1,000unit capsules : 1
Colecalciferol 20,000unit tablets : 1
Colecalciferol 50,000unit tablets : 1
Colecalciferol 2,000unit tablets : 1
Colecalciferol 20,000unit capsules : 1
Pro D3 2,000units/ml liquid : 1
SunVit-D3 400unit tablets : 1
Fultium-D3 3,200unit capsules : 1
Fultium-D3 2,740units/ml oral drops : 1
InVita D3 50,000units/1ml oral solution : 1
Accrete D3 tablets : 14
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 28
InVita D3 400unit capsules : 4
Valupak Vitamin D3 1,000unit tablets : 8
Colecalciferol 800unit capsules : 3
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 3
Colecalciferol 25,000units/1ml soln ud amp sugar free : 3
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 3
InVita D3 25,000units/1ml oral solution : 3
Stexerol-D3 1,000unit tablets : 3
Adcal-D3 Lemon chewable tablets : 16
Calci-D 1000mg/1,000unit chewable tablets : 16
Calceos 500mg/400unit chewable tablets : 11
Fultium-D3 800unit capsules : 25
Evacal D3 1500mg/400unit chewable tablets : 25
InVita D3 800unit capsules : 6
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 10
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 10
Calcichew D3 Forte chewable tablets : 24
Colecalciferol 800unit tablets : 5
Calfovit D3 oral powder sachets : 5
InVita D3 50,000unit capsules : 5
Famotidine 0 H2-Receptor antagonists 1 0.00 0.78 0.23 -3.34
Naproxen 286 Non-steroidal anti-inflammatory drugs 639 0.45 0.69 0.10 -2.38
Neomycin sulfate 12 Nasal preparations for infection 24 0.50 0.84 0.14 -2.37