Static outliers for Buckinghamshire, Oxfordshire And Berkshire West 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 Buckinghamshire, Oxfordshire And Berkshire West STP is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Phenylephrine hydrochloride and tropicamide 1 Mydriatics and cycloplegics 919 0.0 0.0 0.0 6.33
Anakinra 5 Rheumatic disease suppressant drugs 54396 0.0 0.0 0.0 6.33
Clozapine 492 Antipsychotic drugs 101817 0.0 0.0 0.0 6.05
Yellow fever 1 Vaccines and antisera 9225 0.0 0.0 0.0 5.76
Sultiame 42 Control of epilepsy 282880 0.0 0.0 0.0 4.90

Prescribing where Buckinghamshire, Oxfordshire And Berkshire West STP is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Doxycycline hyclate 19983 Tetracyclines 41859 0.48 0.64 0.06 -2.90
Calcipotriol 10264 Preparations for psoriasis 12522 0.82 0.87 0.02 -2.49
Levothyroxine sodium 379020 Thyroid hormones 380649 1.00 1.00 0.00 -2.36
Amitriptyline hydrochloride 146478 Tricyclic and related antidepressant drugs 188849 0.78 0.85 0.03 -2.27
Ropinirole hydrochloride 4241 Dopaminergic drugs used in parkinsonism 48298 0.09 0.16 0.03 -2.23
Ropinirole 250microgram tablets : 491
Ropinirole 1mg tablets : 835
Ropinirole 2mg tablets : 558
Ropinirole 5mg tablets : 35
Ropinirole 500microgram tablets : 767
Ropinirole 2mg modified-release tablets : 158
Ropinirole 4mg modified-release tablets : 173
Ropinirole 8mg modified-release tablets : 156
Ropinirole 3mg modified-release tablets : 29
Ropinirole 6mg modified-release tablets : 87
ReQuip 1mg tablets : 13
ReQuip 2mg tablets : 8
ReQuip 5mg tablets : 4
ReQuip XL 2mg tablets : 26
ReQuip XL 4mg tablets : 38
ReQuip XL 8mg tablets : 96
Adartrel 500microgram tablets : 6
Adartrel 2mg tablets : 5
Spiroco XL 2mg tablets : 150
Spiroco XL 8mg tablets : 92
Repinex XL 4mg tablets : 106
Repinex XL 8mg tablets : 125
Repinex XL 2mg tablets : 81
Ipinnia XL 2mg tablets : 45
Ipinnia XL 4mg tablets : 97
Ipinnia XL 6mg tablets : 17
Ipinnia XL 8mg tablets : 43