Static outliers for Crosby Village 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 Crosby Village Surgery is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Phenobarbital sodium 1 Control of epilepsy 845 0.00 0.00 0.00 17.98
Hyetellose 6 Tear deficiency, eye lubricant/astringent 62 0.10 0.01 0.01 6.25
Dantrolene sodium 10 Skeletal muscle relaxants 28 0.36 0.02 0.06 6.08
Hepatitis B 1 Vaccines and antisera 1 1.00 0.13 0.22 4.01
Salicylic acid 1 Preparations for psoriasis 29 0.03 0.00 0.01 3.50

Prescribing where Crosby Village Surgery is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Donepezil hydrochloride 3 Drugs for dementia 40 0.08 0.49 0.19 -2.25
Colecalciferol 602 Vitamin D 663 0.91 0.96 0.02 -2.23
Colecalciferol 800unit capsules : 31
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 79
Colecalciferol 20,000unit capsules : 85
Adcal-D3 chewable tablets tutti frutti : 181
Adcal-D3 750mg/200unit caplets : 41
Calcichew D3 Forte chewable tablets : 67
Colecalciferol 1,000unit / Calcium carbonate 2.5g chew tab : 2
Colecalciferol 20,000unit tablets : 1
Colecalciferol 40,000unit capsules : 1
Colecalciferol 2,000unit tablets : 1
Colecalciferol 880unit / Calcium carbonate 2.5g chew tab : 1
Colecalciferol 50,000unit capsules : 1
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 4
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 4
Colecalciferol 400unit tablets : 4
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 22
Colecalciferol 1,000unit tablets : 3
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 6
Adcal-D3 Lemon chewable tablets : 6
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 6
Calcichew D3 chewable tablets : 6
SunVit-D3 20,000unit tablets : 6
Fultium-D3 20,000unit capsules : 10
Calceos 500mg/400unit chewable tablets : 5
Desunin 800unit tablets : 5
TheiCal-D3 1000mg/880unit chewable tablets : 5
Fultium-D3 800unit capsules : 19
Prucalopride 0 Other drugs used in constipation 7 0.00 0.71 0.33 -2.18
Benzoyl peroxide and clindamycin phosphate 3 Topical preparations for acne 30 0.10 0.38 0.14 -2.01
Risperidone 0 Antipsychotic drugs 384 0.00 0.16 0.08 -1.99