Static outliers for Woodlands Medical Practice

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 Woodlands Medical Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Azilsartan medoxomil 5 Angiotensin-II receptor antagonists 601 0.01 0.0 0.00 22.56
Ketamine hydrochloride 5 Drugs used in nausea and vertigo 218 0.02 0.0 0.00 18.68
Piroxicam 8 Non-steroidal anti-inflammatory drugs 235 0.03 0.0 0.00 9.51
Eprosartan 31 Angiotensin-II receptor antagonists 601 0.05 0.0 0.01 8.77
Propiverine hydrochloride 21 Drugs for urinary frequency enuresis and incontinence 259 0.08 0.0 0.01 8.57

Prescribing where Woodlands Medical Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Aciclovir 9 Herpes simplex and varicella-zoster 15 0.60 0.95 0.07 -5.14
Spironolactone 27 Potassium-sparing diuretics and aldosterone antagonists 119 0.23 0.72 0.14 -3.59
Colecalciferol 588 Vitamin D 652 0.90 0.96 0.02 -2.48
Colecalciferol 800unit capsules : 42
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 111
Adcal-D3 chewable tablets tutti frutti : 234
Adcal-D3 750mg/200unit caplets : 33
Calcichew D3 Forte chewable tablets : 41
Hux D3 20,000unit capsules : 74
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 2
Adcal-D3 Lemon chewable tablets : 2
Stexerol-D3 1,000unit tablets : 2
Colecalciferol 10,000units/ml oral drops sugar free : 1
Colecalciferol 2,400units/ml oral drops sugar free : 1
Colecalciferol 2,500unit capsules : 1
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 1
Cacit D3 effervescent granules sachets : 1
Calcichew D3 chewable tablets : 1
SunVit-D3 10,000unit capsules : 1
Colecalciferol 1,000unit capsules : 3
Fultium-D3 800unit capsules : 3
Colecalciferol 400unit capsules : 7
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 6
Calceos 500mg/400unit chewable tablets : 6
Evacal D3 1500mg/400unit chewable tablets : 10
Accrete D3 tablets : 5
Azathioprine 19 Antiproliferative immunosuppressants 51 0.37 0.80 0.19 -2.32
Trimethoprim 54 Sulfonamides and trimethoprim 92 0.59 0.86 0.13 -2.15