Static outliers for Westminster Surgery
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 Westminster Surgery is higher than most
| BNF Chemical | Chemical Items | BNF Subparagraph | Subparagraph Items | Ratio | Mean | std | Z_Score | Plots |
|---|---|---|---|---|---|---|---|---|
| Testosterone enantate | 6 | Male sex hormones and antagonists | 78 | 0.08 | 0.00 | 0.01 | 11.73 |  |
| Other eye tear/lubricant/astringent preparations | 5 | Tear deficiency, eye lubricant/astringent | 38 | 0.13 | 0.01 | 0.02 | 5.93 |  |
| Prazosin hydrochloride | 6 | Alpha-adrenoceptor blocking drugs | 79 | 0.08 | 0.00 | 0.01 | 5.90 |  |
| Nifedipine | 162 | Calcium-channel blockers | 1015 | 0.16 | 0.03 | 0.02 | 5.73 |  |
Nifedipine 5mg capsules : 33 Nifedipine 10mg capsules : 66 Nifedipine 10mg modified-release tablets : 2 Adipine XL 30mg tablets : 1 Coracten SR 10mg capsules : 9 Nifedipine 20mg modified-release capsules : 3 Coracten XL 60mg capsules : 7 Nifedipine 30mg modified-release tablets : 6 Nifedipine 60mg modified-release tablets : 10 Coracten XL 30mg capsules : 10 Nifedipine 30mg modified-release capsules : 5 Adipine MR 10 tablets : 5 Adanif XL 60mg tablets : 5 | ||||||||
| Erythromycin stearate | 3 | Macrolides | 59 | 0.05 | 0.00 | 0.01 | 5.39 |  |
Prescribing where Westminster Surgery is lower than most
| BNF Chemical | Chemical Items | BNF Subparagraph | Subparagraph Items | Ratio | Mean | std | Z_Score | Plots |
|---|---|---|---|---|---|---|---|---|
| Carbocisteine | 88 | Mucolytics | 133 | 0.66 | 0.97 | 0.08 | -3.85 |  |
| Doxazosin mesilate | 73 | Alpha-adrenoceptor blocking drugs | 79 | 0.92 | 0.99 | 0.02 | -3.37 |  |
| Cabergoline | 0 | Bromocriptine and other dopaminergic drugs | 1 | 0.00 | 0.86 | 0.27 | -3.16 |  |
| Hydralazine hydrochloride | 0 | Vasodilator antihypertensive drugs | 5 | 0.00 | 0.85 | 0.28 | -3.01 |  |
| Finasteride | 38 | Male sex hormones and antagonists | 78 | 0.49 | 0.82 | 0.12 | -2.88 |  |