Skip to main content

Prototype Prescribing Outlier Dashboard for Barnsley PCN

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 PCNs. From this we can calculate the “z-score”, which is a measure of how many standard deviations a given PCN 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 PCN's chemical:subparagraph ratios is provided, with this PCN'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 Barnsley PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Darifenacin hydrobromide 4,807 Drugs for urinary frequency enuresis and incontinence 39,069 0.12 0.01 0.03 4.31
Ibandronic acid 2,440 Bisphosphonates and other drugs 24,716 0.10 0.02 0.02 3.74
Cyproterone acetate 31 Male sex hormones and antagonists 18,302 0.00 0.00 0.00 3.61
Monobasic potassium phosphate 2 Phosphate supplements 44 0.05 0.00 0.01 3.57
Dorzolamide 3,551 Treatment of glaucoma 33,411 0.11 0.04 0.02 3.53
Taurine 60 Amino acids and nutritional agents 113 0.53 0.04 0.16 3.05
Ethinylestradiol 4 Oestrogens and Hormone Replacement Therapy 7,941 0.00 0.00 0.00 2.60
Indacaterol/glycopyrronium 3,948 Compound bronchodilator preparations 7,309 0.54 0.15 0.15 2.57
Testosterone 2,943 Male sex hormones and antagonists 18,302 0.16 0.07 0.04 2.52
Fluoxetine hydrochloride 43,359 Selective serotonin re-uptake inhibitors 190,022 0.23 0.16 0.03 2.28

Prescribing where Barnsley PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Other amino acidandnutritional agent preparations 53 Amino acids and nutritional agents 113 0.47 0.96 0.16 -3.05
Brinzolamide 821 Treatment of glaucoma 33,411 0.02 0.10 0.03 -2.63
Glycopyrronium bromide 1 Antimuscarinic drugs 8 0.12 0.78 0.36 -1.80
Other food for special diet preparations 1,608 Foods for special diets 4,714 0.34 0.64 0.17 -1.76
Adapalene and benzoyl peroxide 251 Topical preparations for acne 4,203 0.06 0.17 0.07 -1.69
Umeclidinium bromide/vilanterol 903 Compound bronchodilator preparations 7,309 0.12 0.50 0.25 -1.51
Clarithromycin 3,860 Macrolides 9,442 0.41 0.58 0.12 -1.51
Gentamicin sulfate 2 Aminoglycosides 16 0.12 0.74 0.41 -1.49
Tamoxifen citrate 1,233 Breast cancer 8,030 0.15 0.27 0.08 -1.48
Bimatoprost 1,308 Treatment of glaucoma 33,411 0.04 0.11 0.05 -1.47