Static outliers for Limelight Health And Wellbeing Hub

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 Limelight Health And Wellbeing Hub is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Salicylic acid 6 Preparations for psoriasis 56 0.11 0.00 0.01 11.42
Flavoxate hydrochloride 25 Drugs for urinary frequency enuresis and incontinence 803 0.03 0.00 0.01 5.16
Oxycodone hydrochloride 454 Opioid analgesics 1530 0.30 0.08 0.05 4.33
Domperidone 154 Drugs used in nausea and vertigo 650 0.24 0.05 0.04 4.28
Hydrogen peroxide 1 Oxidisers and dyes 1 1.00 0.06 0.22 4.25

Prescribing where Limelight Health And Wellbeing Hub is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Potassium permanganate 0 Oxidisers and dyes 1 0.00 0.94 0.22 -4.21
Quinine sulfate 99 Antimalarials 199 0.50 0.89 0.14 -2.80
Colecalciferol 1811 Vitamin D 2000 0.91 0.96 0.02 -2.33
Colecalciferol 800unit capsules : 72
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 45
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 29
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 34
Accrete D3 tablets : 314
Adcal-D3 chewable tablets tutti frutti : 459
Adcal-D3 750mg/200unit caplets : 372
Calceos 500mg/400unit chewable tablets : 52
Calcichew D3 chewable tablets : 55
Calcichew D3 Forte chewable tablets : 108
InVita D3 50,000unit capsules : 56
Colecalciferol 2,000unit tablets : 2
Evacal D3 1500mg/400unit chewable tablets : 2
InVita D3 2,400units/ml oral drops : 2
InVita D3 50,000units/1ml oral solution : 2
InVita D3 25,000unit capsules : 2
Colecalciferol 3,200unit capsules : 1
Colecalciferol 25,000units/1ml soln ud amp sugar free : 1
Colecalciferol 25,000unit tablets : 1
Colecalciferol 4,000unit tablets : 1
Colecalciferol 25,000unit capsules : 1
SunVit-D3 10,000unit capsules : 1
Fultium-D3 800unit capsules : 28
Hux D3 20,000unit capsules : 4
Thorens 25,000units/2.5ml oral solution : 4
Colecalciferol 400unit capsules : 18
Colecalciferol 400unit tablets : 18
Colecalciferol 20,000unit capsules : 13
Adcal-D3 Lemon chewable tablets : 12
Stexerol-D3 25,000unit tablets : 7
Colecalciferol 20,000unit tablets : 25
Colecalciferol 50,000unit capsules : 6
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 20
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 10
Colecalciferol 1,000unit tablets : 5
SunVit-D3 400unit tablets : 5
InVita D3 25,000units/1ml oral solution : 5
Colecalciferol 800unit tablets : 19
Prednisolone 290 Use of corticosteroids 389 0.75 0.88 0.06 -2.13
Budesonide 0 Corticosteroids 3 0.00 0.70 0.34 -2.08