Static outliers for Burnley 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 Burnley Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Combined mestranol 2 Combined hormonal contraceptives 119 0.02 0.0 0.00 25.51
Dornase alfa 5 Mucolytics 54 0.09 0.0 0.01 8.45
Doxycycline hyclate 3 Drugs for oral ulceration and inflammation 18 0.17 0.0 0.02 8.00
Hamamalis 4 Other anti-inflammatory preparations 91 0.04 0.0 0.01 5.46
Paraffin soft white 6 Emollients 217 0.03 0.0 0.01 4.65

Prescribing where Burnley Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Water for injection 0 Electrolytes and water 6 0.00 0.82 0.26 -3.14
Carbimazole 18 Antithyroid drugs 29 0.62 0.93 0.11 -2.93
Budesonide 0 Corticosteroids 2 0.00 0.70 0.34 -2.08
Benzydamine hydrochloride 8 Drugs for oral ulceration and inflammation 18 0.44 0.83 0.18 -2.06
Colecalciferol 650 Vitamin D 710 0.92 0.96 0.02 -1.93
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 70
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 33
Adcal-D3 chewable tablets tutti frutti : 112
Calceos 500mg/400unit chewable tablets : 45
Fultium-D3 800unit capsules : 42
Desunin 800unit tablets : 41
Stexerol-D3 1,000unit tablets : 106
Colecalciferol 800unit capsules : 2
Colecalciferol 1,000unit tablets : 2
Colecalciferol 1,000unit capsules : 2
Colecalciferol 20,000unit tablets : 2
Colecalciferol 2,000unit tablets : 2
Solgar Vitamin D3 1,000unit tablets : 2
Valupak Vitamin D3 1,000unit tablets : 2
SunVit-D3 2,000unit tablets : 2
SunVit-D3 1,000unit capsules : 2
Evacal D3 1500mg/400unit chewable tablets : 2
Colecalciferol 2,000units/ml oral drops sugar free : 1
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 1
Colecalciferol 800unit tablets : 1
Pro D3 20,000unit capsules : 1
Bio-Vitamin D3 5,000unit capsules : 1
InVita D3 2,400units/ml oral drops : 1
InVita D3 800unit capsules : 1
Adcal-D3 750mg/200unit caplets : 9
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 4
Hux D3 20,000unit capsules : 4
Plenachol D3 20,000unit capsules : 4
Colecalciferol 400unit / Calcium carbonate 1.5g tablets : 8
Adcal-D3 Lemon chewable tablets : 8
InVita D3 50,000unit capsules : 8
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 3
Colecalciferol 10,000unit tablets : 3
Colecalciferol 20,000unit capsules : 3
Plenachol D3 40,000unit capsules : 3
Thorens 25,000units/2.5ml oral solution : 3
Calcichew D3 Forte chewable tablets : 26
Stexerol-D3 25,000unit tablets : 7
Fultium-D3 20,000unit capsules : 11
InVita D3 50,000units/1ml oral solution : 11
Accrete D3 tablets : 25
Colecalciferol 3,000unit tablets : 6
Colecalciferol 2,400units/ml oral drops sugar free : 6
Accrete D3 One a Day 1000mg/880unit chewable tablets : 6
InVita D3 25,000units/1ml oral solution : 6
Colecalciferol 400unit / Calcium carbonate 1.5g efferv tab : 5
Calci-D 1000mg/1,000unit chewable tablets : 5