Static outliers for The Range 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 The Range Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Povidone iodine 6 Ocular diagnostic & peri-operative prepn & photodynamic tt 20 0.30 0.00 0.01 55.42
Hydrocortisone sodium succinate 7 Use of corticosteroids 224 0.03 0.00 0.00 10.55
Nifedipine 667 Calcium-channel blockers 2611 0.26 0.03 0.02 9.96
Hepatitis A 1 Vaccines and antisera 1 1.00 0.05 0.11 8.64
Flumetasone pivalate 8 Otitis externa 61 0.13 0.01 0.02 6.14

Prescribing where The Range Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Potassium citrate 0 Drugs used in urological pain 1 0.00 0.93 0.24 -3.87
Colecalciferol 864 Vitamin D 956 0.90 0.96 0.02 -2.40
Colecalciferol 800unit capsules : 31
Colecalciferol 1,000unit tablets : 47
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 53
Adcal-D3 chewable tablets tutti frutti : 120
Adcal-D3 750mg/200unit caplets : 224
Calceos 500mg/400unit chewable tablets : 41
Calcichew D3 Forte chewable tablets : 108
Hux D3 20,000unit capsules : 94
Colecalciferol 2,000unit tablets : 2
Accrete D3 tablets : 2
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 1
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 1
Fultium-D3 20,000unit capsules : 1
Thorens 10,000units/ml oral drops : 1
Adcal-D3 Lemon chewable tablets : 4
Colecalciferol 400unit tablets : 13
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 22
Colecalciferol 400unit capsules : 12
Colecalciferol 800unit tablets : 26
Colecalciferol 20,000unit capsules : 7
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 7
Fultium-D3 800unit capsules : 25
Colecalciferol 1,000unit capsules : 6
Calcichew D3 chewable tablets : 6
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 10
Ivermectin 1 Topical preparation for rosacea 3 0.33 0.88 0.24 -2.30
Prucalopride 0 Other drugs used in constipation 1 0.00 0.71 0.33 -2.18
Estradiol 4 Preparations for vaginal/vulval changes 47 0.09 0.55 0.21 -2.17