Static outliers for Coventry And Warwickshire 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 Coventry And Warwickshire STP is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Other preparations for biliary disorders 5 Drugs affecting biliary composition and flow 2167 0.0 0.0 0.0 6.33
Glucose/glycerol 1 Topical nasal decongestants 2010 0.0 0.0 0.0 6.33
Cariprazine 167 Antipsychotic drugs 80654 0.0 0.0 0.0 6.02
Clomethiazole edisilate 102 Hypnotics 61868 0.0 0.0 0.0 5.94
Adalimumab 5 Rheumatic disease suppressant drugs 16494 0.0 0.0 0.0 5.72

Prescribing where Coventry And Warwickshire STP is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ursodeoxycholic acid 2162 Drugs affecting biliary composition and flow 2167 1.00 1.00 0.00 -6.04
Entecavir 8 Chronic hepatitis B 14 0.57 0.95 0.13 -2.98
Other phosphate supplement preparations 97 Phosphate supplements 101 0.96 0.99 0.01 -2.76
Medroxyprogesterone acetate 1 Progestogens 44 0.02 0.61 0.22 -2.63
Olanzapine 10655 Antipsychotic drugs 80654 0.13 0.22 0.04 -2.50
Olanzapine 5mg tablets : 2621
Olanzapine 7.5mg tablets : 518
Olanzapine 10mg tablets : 3842
Olanzapine 2.5mg tablets : 1414
Olanzapine 5mg oral lyophilisates sugar free : 8
Olanzapine 10mg oral lyophilisates sugar free : 1
Olanzapine 15mg tablets : 813
Olanzapine 20mg oral lyophilisates sugar free : 5
Olanzapine 20mg tablets : 1019
Olanzapine 5mg orodispersible tablets sugar free : 63
Olanzapine 10mg orodispersible tablets sugar free : 108
Olanzapine 15mg orodispersible tablets sugar free : 5
Olanzapine 20mg orodispersible tablets sugar free : 74
Olanzapine 5mg orodispersible tablets : 33
Olanzapine 10mg orodispersible tablets : 48
Olanzapine 15mg orodispersible tablets : 24
Olanzapine 20mg orodispersible tablets : 18
Olanzapine 2.5mg/5ml oral suspension : 5
Zyprexa 5mg tablets : 3
Zyprexa 10mg tablets : 11
Zyprexa 2.5mg tablets : 10
Zyprexa 5mg Velotabs : 7
Zyprexa 20mg Velotabs : 5