Static outliers for Stockbridge Village Hc

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 Stockbridge Village Hc is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Aluminium and magnesium and oxetacaine 7 Antacids and simeticone 8 0.88 0.04 0.15 5.56
Mycophenolic sodium 6 Antiproliferative immunosuppressants 45 0.13 0.01 0.03 4.93
Propafenone hydrochloride 5 Drugs for arrhythmias 18 0.28 0.02 0.05 4.81
Pilocarpine hydrochloride 18 Treatment of glaucoma 476 0.04 0.00 0.01 4.76
Bromfenac 1 Ocular diagnostic & peri-operative prepn & photodynamic tt 1 1.00 0.09 0.23 3.99

Prescribing where Stockbridge Village Hc is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Carbocisteine 328 Mucolytics 423 0.78 0.97 0.08 -2.44
Glucose blood testing reagents 479 Diabetic diagnostic and monitoring agents 550 0.87 0.95 0.03 -2.20
Colecalciferol 1920 Vitamin D 2087 0.92 0.96 0.02 -1.75
Colecalciferol 800unit capsules : 234
Colecalciferol 400unit capsules : 52
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 30
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 85
Colecalciferol 20,000unit capsules : 391
Adcal-D3 chewable tablets tutti frutti : 323
Adcal-D3 750mg/200unit caplets : 92
Calcichew D3 chewable tablets : 130
Calcichew D3 Forte chewable tablets : 284
Fultium-D3 800unit capsules : 113
Colecalciferol 10,000units/ml oral drops sugar free : 2
Colecalciferol 2,740units/ml oral drops sugar free : 2
Colecalciferol 400unit tablets : 2
Colecalciferol 200units/drop oral drops : 2
Pro D3 400unit capsules : 2
Colecalciferol 5,000unit tablets : 1
Pro D3 10,000unit capsules : 1
InVita D3 25,000unit capsules : 1
Evacal D3 1500mg/400unit chewable tablets : 14
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 9
Desunin 800unit tablets : 9
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 4
Colecalciferol 20,000unit tablets : 4
Fultium-D3 20,000unit capsules : 18
Adcal-D3 Lemon chewable tablets : 8
Colecalciferol 40,000unit capsules : 3
Natecal D3 600mg/400unit chewable tablets : 3
Colecalciferol 25,000unit capsules : 7
InVita D3 25,000units/1ml oral solution : 7
Accrete D3 tablets : 21
InVita D3 800unit capsules : 11
Cacit D3 effervescent granules sachets : 6
Calfovit D3 oral powder sachets : 6
Colecalciferol 800unit tablets : 24
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 19
Tacrolimus 5 Drugs affecting the immune response 11 0.45 0.81 0.21 -1.70
Azathioprine 22 Antiproliferative immunosuppressants 45 0.49 0.80 0.19 -1.70