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Prototype Prescribing Outlier Dashboard for Chessington And Surbiton 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 Chessington And Surbiton PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Paracetamol and ibuprofen 3 Non-opioid analgesics and compound preparations 5,065 0.00 0.00 0.00 13.20
Benzydamine hydrochloride 3 Rubefacients, topical NSAIDS, capsaicin and poultice 635 0.00 0.00 0.00 10.37
Mometasone/glycopyrronium/indacaterol 7 Corticosteroids (respiratory) 4,830 0.00 0.00 0.00 8.23
Low protein biscuits 21 Foods for special diets 222 0.09 0.01 0.01 7.32
Quinapril hydrochloride with diuretic 3 Angiotensin-converting enzyme inhibitors 10,214 0.00 0.00 0.00 5.72
Phenylbutazone 1 Non-steroidal anti-inflammatory drugs 2,007 0.00 0.00 0.00 5.10
Other psoriasis preparations 2 Preparations for psoriasis 220 0.01 0.00 0.00 4.60
Torasemide 36 Loop diuretics 3,195 0.01 0.00 0.00 4.40
Calcium acetate/magnesium carbonate 7 Phosphate binding agents 11 0.64 0.05 0.14 4.29
Selegiline hydrochloride 32 Dopaminergic drugs used in parkinsonism 875 0.04 0.01 0.01 4.07

Prescribing where Chessington And Surbiton PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Acamprosate calcium 0 Alcohol dependence 2 0.00 0.83 0.23 -3.54
    Paroxetine hydrochloride 79 Selective serotonin re-uptake inhibitors 9,863 0.01 0.03 0.01 -2.35
    Topiramate 72 Control of epilepsy 5,992 0.01 0.04 0.01 -2.34
    Levothyroxine sodium 7,747 Thyroid hormones 7,792 0.99 1.00 0.00 -2.23
    Glyceryl trinitrate 178 Nitrates 1,451 0.12 0.26 0.07 -2.10
    Ganciclovir 0 Antivirals 1 0.00 0.65 0.33 -2.00
      Fluconazole 98 Triazole antifungals 135 0.73 0.86 0.07 -1.98
      Prucalopride 3 Other drugs used in constipation 8 0.38 0.73 0.19 -1.93
      Clonidine hydrochloride 14 Prophylaxis of migraine 117 0.12 0.37 0.13 -1.87
      Hypromellose 185 Tear deficiency, eye lubricant/astringent 722 0.26 0.45 0.11 -1.83