Static outliers for Parkgate 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 Parkgate Surgery is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Eprosartan 108 Angiotensin-II receptor antagonists 1528 0.07 0.00 0.01 12.13
Other calcium supplement preparations 5 Calcium supplements 7 0.71 0.04 0.12 5.39
Antazoline 6 Other anti-inflammatory preparations 41 0.15 0.01 0.03 4.84
Acetic acid 24 Otitis externa 87 0.28 0.04 0.06 4.08
Levomepromazine hydrochloride 36 Antipsychotic drugs 537 0.07 0.01 0.02 3.65

Prescribing where Parkgate Surgery is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Calcium carbonate 2 Calcium supplements 7 0.29 0.95 0.13 -5.00
Midazolam hydrochloride 1 Drugs used in status epilepticus 23 0.04 0.79 0.30 -2.48
Colecalciferol 1355 Vitamin D 1501 0.90 0.96 0.02 -2.44
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 100
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 584
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 29
Colecalciferol 20,000unit capsules : 61
Accrete D3 tablets : 47
Adcal-D3 chewable tablets tutti frutti : 162
Adcal-D3 Lemon chewable tablets : 36
Adcal-D3 750mg/200unit caplets : 74
Calcichew D3 Forte chewable tablets : 64
Fultium-D3 800unit capsules : 34
Colecalciferol 800unit/Calcium phosphate 3.1g oral pdr sach : 2
Calcichew D3 chewable tablets : 2
InVita D3 25,000units/1ml oral solution : 2
Calci-D 1000mg/1,000unit chewable tablets : 2
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 1
Kora LiquiD 3000units/ml oral solution : 1
Hux D3 20,000unit capsules : 14
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 9
Natecal D3 600mg/400unit chewable tablets : 4
Colecalciferol 800unit capsules : 27
Fultium-D3 20,000unit capsules : 22
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 3
Colecalciferol 25,000unit capsules : 3
BabyD 1,000units/ml oral solution : 3
Pro D3 20,000unit capsules : 3
Evacal D3 1500mg/400unit chewable tablets : 3
Stexerol-D3 25,000unit tablets : 3
Colecalciferol 25,000unit tablets : 7
Desunin 800unit tablets : 25
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 6
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 6
Colecalciferol 10,000unit capsules : 6
Colecalciferol 800unit / Calcium carbonate 2.5g chewable tab : 5
Stexerol-D3 1,000unit tablets : 5
Methylprednisolone acetate 1 Local corticosteroid injections 81 0.01 0.73 0.39 -1.84
Estriol 19 Preparations for vaginal/vulval changes 198 0.10 0.45 0.21 -1.67