Static outliers for Staffordshire & Stoke On Trent STP

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 Staffordshire & Stoke On Trent STP is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Primaquine 1 Antimalarials 30121 0.00 0.0 0.00 6.33
Flurazepam hydrochloride 1 Hypnotics 59712 0.00 0.0 0.00 6.33
Sodium aurothiomalate 3 Rheumatic disease suppressant drugs 31029 0.00 0.0 0.00 6.28
Idebenone 5 Other eye preparations 86 0.06 0.0 0.01 6.21
Ibuprofen lysine 196 Non-steroidal anti-inflammatory drugs 86633 0.00 0.0 0.00 6.04

Prescribing where Staffordshire & Stoke On Trent STP is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Carbomer 81 Other eye preparations 86 0.94 1.00 0.01 -6.21
Carbocisteine 26181 Mucolytics 34260 0.76 0.97 0.05 -3.99
Desmopressin acetate 2217 Posterior pituitary hormones and antagonists 2228 1.00 1.00 0.00 -3.42
Desmopressin 10micrograms/dose nasal spray : 161
Desmopressin 100microgram tablets : 392
Desmopressin 200microgram tablets : 838
Desmopressin 10micrograms/ml intranasal solution : 2
Desmopressin 200micrograms/5ml oral liquid : 2
Desmopressin 120microgram oral lyophilisates sugar free : 227
Desmopressin 60microgram oral lyophilisates sugar free : 14
Desmopressin 240microgram oral lyophilisates sugar free : 124
Desmopressin 50microgram oral lyophilisates sugar free : 21
Desmopressin 25microgram oral lyophilisates sugar free : 23
DDAVP 0.2mg tablets : 8
DDAVP 0.1mg tablets : 24
DDAVP Melt 60microgram oral lyophilisates : 22
DDAVP Melt 120microgram oral lyophilisates : 9
Desmospray 10micrograms/dose nasal spray : 8
Desmotabs 0.2mg tablets : 42
DesmoMelt 120microgram oral lyophilisates : 185
DesmoMelt 240microgram oral lyophilisates : 98
Noqdirna 50microgram oral lyophilisates : 13
Noqdirna 25microgram oral lyophilisates : 4
Filgrastim 0 Drugs used in neutropenia 7 0.00 0.85 0.33 -2.57
Lithium carbonate 2820 Drugs used for mania and hypomania 7712 0.37 0.61 0.12 -2.06