Static outliers for Soho Health Centre

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 Soho Health Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
INR blood testing reagents 6 Oral anticoagulants 237 0.03 0.00 0.00 8.41
Acenocoumarol 6 Oral anticoagulants 237 0.03 0.00 0.00 7.90
Magnesium trisilicate 4 Antacids and simeticone 4 1.00 0.03 0.14 7.11
Gluten free/wheat free grains/flours 7 Foods for special diets 173 0.04 0.00 0.01 6.98
Levofloxacin 2 Quinolones 3 0.67 0.05 0.09 6.97

Prescribing where Soho Health Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ciprofloxacin 1 Quinolones 3 0.33 0.86 0.15 -3.53
Colecalciferol 515 Vitamin D 588 0.88 0.96 0.02 -3.53
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 42
Adcal-D3 chewable tablets tutti frutti : 45
Adcal-D3 750mg/200unit caplets : 67
InVita D3 50,000unit capsules : 148
Calci-D 1000mg/1,000unit chewable tablets : 115
Colecalciferol 800unit capsules : 2
Colecalciferol 400unit capsules : 2
Pro D3 forte 3,000units/ml liquid : 2
Colecalciferol 800unit tablets : 1
Colecalciferol 20,000unit capsules : 1
Colecalciferol 25,000unit capsules : 1
Colecalciferol 50,000unit capsules : 1
Calcichew D3 Forte chewable tablets : 1
SunVit-D3 10,000unit capsules : 1
Aciferol D3 3,000units/ml liquid : 1
InVita D3 25,000units/1ml oral solution : 1
InVita D3 50,000units/1ml oral solution : 1
InVita D3 800unit capsules : 1
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 28
Colecalciferol 400unit / Calcium carbonate 1.25g chew tab : 9
Colecalciferol 20,000unit tablets : 4
Accrete D3 tablets : 18
Colecalciferol 200unit / Calcium carbonate 1.25g chew tab : 8
Colecalciferol 1,000unit capsules : 3
Colecalciferol 50,000units/1ml soln ud amp sugar free : 3
Fultium-D3 800unit capsules : 3
Pro D3 2,000units/ml liquid drops : 6
Somatropin 0 Hypothalamic & anterior pituitary hormone & antioestrogens 1 0.00 0.90 0.27 -3.31
Water for injection 0 Electrolytes and water 1 0.00 0.82 0.26 -3.14
Alendronic acid 54 Bisphosphonates and other drugs 85 0.64 0.87 0.09 -2.56