Static outliers for Ellergreen 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 Ellergreen Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Clemastine fumarate 20 Antihistamines 1629 0.01 0.00 0.00 24.67
Acipimox 12 Lipid-regulating drugs 6444 0.00 0.00 0.00 14.90
Benzydamine hydrochloride 13 Rubefacients, topical NSAIDS, capsaicin and poultice 1251 0.01 0.00 0.00 9.34
Moxifloxacin hydrochloride 1 Ocular diagnostic & peri-operative prepn & photodynamic tt 1 1.00 0.03 0.12 8.41
Triptorelin embonate 10 Prostate cancer and gonadorelin analogues 22 0.45 0.02 0.07 5.76

Prescribing where Ellergreen Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Urea hydrogen peroxide 0 Removal of ear wax and other substances 2 0.00 0.83 0.34 -2.47
Allopurinol 412 Gout and cytotoxic induced hyperiuicaemia 527 0.78 0.89 0.05 -2.11
Glucose blood testing reagents 641 Diabetic diagnostic and monitoring agents 725 0.88 0.95 0.03 -1.80
Macrogol 3350 559 Osmotic laxatives 1048 0.53 0.70 0.10 -1.76
Flecainide acetate 1 Drugs for arrhythmias 51 0.02 0.46 0.25 -1.74