Static outliers for Sunvalley 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 Sunvalley Medical Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Compound antispasmodic preparations 3 Antispasmodic and other drugs altering gut motility 225 0.01 0.00 0.00 111.64
Chlorhexidine gluconate 1 Preparations for minor cuts and abrasions 1 1.00 0.02 0.13 7.66
Loteprednol etabonate 6 Corticosteroids 15 0.40 0.02 0.05 6.93
Ergocalciferol 46 Vitamin D 1005 0.05 0.00 0.01 6.82
Nadolol 8 Beta-adrenoceptor blocking drugs 1183 0.01 0.00 0.00 6.61

Prescribing where Sunvalley Medical Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Folic acid 143 Drugs used in megaloblastic anaemias 617 0.23 0.70 0.16 -2.95
Estradiol 0 Preparations for vaginal/vulval changes 2 0.00 0.55 0.21 -2.57
Prucalopride 0 Other drugs used in constipation 6 0.00 0.71 0.33 -2.18
Spironolactone 52 Potassium-sparing diuretics and aldosterone antagonists 122 0.43 0.72 0.14 -2.13
Colecalciferol 918 Vitamin D 1005 0.91 0.96 0.02 -2.01
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 59
Colecalciferol 20,000unit capsules : 47
Adcal-D3 750mg/200unit caplets : 31
Calcichew D3 Forte chewable tablets : 102
Fultium-D3 800unit capsules : 190
Evacal D3 1500mg/400unit chewable tablets : 229
InVita D3 2,400units/ml oral drops : 2
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 1
Colecalciferol 20,000unit tablets : 1
Colecalciferol 400unit tablets : 1
BabyD 1,000units/ml oral solution : 1
Plenachol D3 20,000unit capsules : 1
Calci-D 1000mg/1,000unit chewable tablets : 1
Strivit-D3 800unit capsules : 1
Calfovit D3 oral powder sachets : 28
Calceos 500mg/400unit chewable tablets : 9
OsteoCaps D3 20,000unit capsules : 9
Adcal-D3 chewable tablets tutti frutti : 23
Colecalciferol 10,000units/ml oral drops sugar free : 4
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 4
Thorens 25,000units/2.5ml oral solution : 4
Fultium-D3 20,000unit capsules : 27
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 8
Colecalciferol 400unit capsules : 3
Colecalciferol 800unit tablets : 3
Colecalciferol 3,200unit capsules : 3
Hux D3 20,000unit capsules : 3
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 17
Colecalciferol 800unit capsules : 21
Colecalciferol 1,000unit tablets : 11
Accrete D3 tablets : 11
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 6
Colecalciferol 440unit/Calcium carb 1.25g efferv gran sach : 6
InVita D3 800unit capsules : 6
Calcichew D3 chewable tablets : 15
Colecalciferol 200units/drop oral drops : 10
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 5
SunVit-D3 400unit tablets : 5
InVita D3 25,000units/1ml oral solution : 5
Thorens 10,000units/ml oral drops : 5