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Prototype Prescribing Outlier Dashboard for NHS Ipswich And East Suffolk CCG

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. These pilot results are provided for the interest of advanced users, although we don't know how relevant they are in 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.

The DataLab is keen to hear your feedback on the results. You can do this by completing the following survey or emailing us at [email protected]. Please DO NOT INCLUDE IDENTIFIABLE PATIENT information in your feedback. All feedback is helpful, you can send short or detailed feedback.

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, the count of all prescriptions within that chemical's BNF subparagraph, for prescriptions dispensed between June 2021 and December 2021. We then calculate the ratio of these counts along with the mean and standard deviation of those ratios across all CCGs. From this we can calculate the “z-score”, which is a measure of how many standard deviations a given CCG is from the population mean. We then rank your “z-scores” to find the top 10 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.

For each outlier chemical, a kernel density estimation plot of all CCG's chemical:subparagraph ratios is provided, with this CCG's ratio overlaid in red.

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, to inform research on this topic. Our full analytical method code is openly available on GitHub here.

This is a new, experimental feature. We'd love to .

Prescribing where NHS Ipswich And East Suffolk CCG is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Secukinumab 3 Rheumatic disease suppressant drugs 16,282 0.00 0.00 0.00 9.21
Hydrocort sodiumphos 606 Antibacterials 5,174 0.12 0.01 0.01 7.89
Tiopronin 5 Rheumatic disease suppressant drugs 16,282 0.00 0.00 0.00 6.78
Etodolac 2,947 Non-steroidal anti-inflammatory drugs 43,416 0.07 0.01 0.01 5.51
Potassium bicarbonate 8 Oral bicarbonate 1,499 0.01 0.00 0.00 5.44
Doxycycline hyclate 27 Drugs for oral ulceration and inflammation 1,267 0.02 0.00 0.00 4.84
Olmesartan medoxomil/amlodipine 517 Angiotensin-II receptor antagonists 99,975 0.01 0.00 0.00 4.20
Silver nitrate 44 Preparations for warts and calluses 178 0.25 0.07 0.04 4.13
Rivastigmine 3,596 Drugs for dementia 15,560 0.23 0.09 0.03 4.08
Paracetamol and caffeine 8 Non-opioid analgesics and compound preparations 106,244 0.00 0.00 0.00 4.08

Prescribing where NHS Ipswich And East Suffolk CCG is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sodium bicarbonate 1,491 Oral bicarbonate 1,499 0.99 1.00 0.00 -5.44
Tiotropium bromide 3,803 Antimuscarinic bronchodilators 14,394 0.26 0.70 0.14 -3.13
Doxycycline hyclate 8,720 Tetracyclines 15,793 0.55 0.71 0.06 -2.62
Iodine compounds 12 Chlorine and iodine 20 0.60 0.95 0.14 -2.58
Tramadol hydrochloride 18,418 Opioid analgesics 115,361 0.16 0.26 0.04 -2.42
Clotrimazole 2,265 Vaginal and vulval infections 2,711 0.84 0.91 0.03 -2.29
Benzydamine hydrochloride 972 Drugs for oral ulceration and inflammation 1,267 0.77 0.87 0.05 -2.27
Zinc oxide 309 Barrier preparations 3,026 0.10 0.45 0.16 -2.17
Doxazosin mesilate 31,028 Alpha-adrenoceptor blocking drugs 31,654 0.98 0.99 0.00 -2.14
Gamolenic acid 14 Preparations for eczema 30 0.47 0.90 0.21 -2.07