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Prototype Prescribing Outlier Dashboard for Barrow And Millom 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 Barrow And Millom PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Secukinumab 1 Rheumatic disease suppressant drugs 3,202 0.00 0.00 0.00 16.63
Hamamelis 6 Soothing haemorrhoidal preparations 64 0.09 0.00 0.02 4.98
Darifenacin hydrobromide 709 Drugs for urinary frequency enuresis and incontinence 5,071 0.14 0.01 0.03 4.96
Clindamycin phosphate 82 Vaginal and vulval infections 654 0.13 0.03 0.02 4.95
Opicapone 168 Dopaminergic drugs used in parkinsonism 3,381 0.05 0.01 0.01 4.26
Ipratropium bromide 877 Antimuscarinic bronchodilators 4,416 0.20 0.07 0.03 3.93
Econazole nitrate 3 Antifungal preparations 1,074 0.00 0.00 0.00 3.37
Other oral iron preparations 70 Oral iron 5,414 0.01 0.00 0.00 3.33
Propylthiouracil 134 Antithyroid drugs 675 0.20 0.07 0.04 3.04
Rizatriptan 629 Treatment of acute migraine 2,487 0.25 0.11 0.05 2.99

Prescribing where Barrow And Millom PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Carbimazole 541 Antithyroid drugs 675 0.80 0.93 0.04 -3.04
Mercaptopurine 39 Antimetabolites 581 0.07 0.81 0.27 -2.72
Indapamide 1,884 Thiazides and related diuretics 10,524 0.18 0.42 0.10 -2.43
Salbutamol 22,688 Selective beta(2)-agonists 27,161 0.84 0.90 0.03 -2.18
Apixaban 2,422 Oral anticoagulants 15,042 0.16 0.41 0.12 -2.02
Ferrous fumarate 1,020 Oral iron 5,414 0.19 0.57 0.20 -1.93
Nitrofurantoin 3,116 Urinary-tract infections 3,585 0.87 0.96 0.05 -1.84
Clotrimazole 533 Vaginal and vulval infections 654 0.81 0.90 0.05 -1.79
Linagliptin 159 Other antidiabetic drugs 4,987 0.03 0.16 0.07 -1.76
Folic acid 6,872 Drugs used in megaloblastic anaemias 15,311 0.45 0.68 0.13 -1.73