Static outliers for Dr A Hamid

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 Dr A Hamid is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Clomethiazole 26 Hypnotics 117 0.22 0.00 0.01 38.93
Naphazoline hydrochloride 6 Other anti-inflammatory preparations 40 0.15 0.00 0.00 31.20
Alogliptin/metformin 234 Other antidiabetic drugs 1196 0.20 0.00 0.02 10.42
Diethylamine salicylate 62 Rubefacients, topical NSAIDS, capsaicin and poultice 110 0.56 0.03 0.06 8.72
Ranitidine hydrochloride 7 H2-Receptor antagonists 7 1.00 0.04 0.12 8.22

Prescribing where Dr A Hamid is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Levothyroxine sodium 439 Thyroid hormones 449 0.98 1.00 0.00 -7.13
Famotidine 0 H2-Receptor antagonists 7 0.00 0.78 0.23 -3.34
Trimethoprim 18 Sulfonamides and trimethoprim 39 0.46 0.86 0.13 -3.12
Colecalciferol 413 Vitamin D 461 0.90 0.96 0.02 -2.72
Accrete D3 tablets : 107
Adcal-D3 chewable tablets tutti frutti : 58
TheiCal-D3 1000mg/880unit chewable tablets : 102
Colecalciferol 1,000unit tablets : 2
Strivit-D3 20,000unit capsules : 2
Colecalciferol 1,000unit capsules : 1
Colecalciferol 200units/drop oral drops sugar free : 1
Colecalciferol 20,000unit capsules : 1
Pro D3 2,000units/ml liquid drops : 1
Fultium-D3 20,000unit capsules : 1
Colecalciferol 800unit capsules : 9
Adcal-D3 750mg/200unit caplets : 9
Colecalciferol 800unit tablets : 4
Calfovit D3 oral powder sachets : 4
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 13
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 3
Calcichew D3 Forte chewable tablets : 12
InVita D3 2,400units/ml oral drops : 12
Colecalciferol 400unit capsules : 7
Fultium-D3 2,740units/ml oral drops : 7
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 16
Cacit D3 effervescent granules sachets : 6
Hux D3 20,000unit capsules : 15
Adcal-D3 Lemon chewable tablets : 10
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 5
Fultium-D3 3,200unit capsules : 5
Estradiol 0 Preparations for vaginal/vulval changes 11 0.00 0.55 0.21 -2.57