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Prototype Prescribing Outlier Dashboard for Wolverhampton Rwt 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 Wolverhampton Rwt PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Granisetron 8 Drugs used in nausea and vertigo 2,838 0.00 0.00 0.00 8.04
Levobunolol hydrochloride 47 Treatment of glaucoma 4,024 0.01 0.00 0.00 6.32
Calcium gluconate 8 Calcium supplements 95 0.08 0.00 0.01 6.04
Perampanel 156 Control of epilepsy 14,352 0.01 0.00 0.00 4.63
Tamsulosin and dutasteride hydrochloride 458 Drugs for urinary retention 4,217 0.11 0.02 0.02 4.61
Imidapril hydrochloride 33 Angiotensin-converting enzyme inhibitors 18,163 0.00 0.00 0.00 3.75
Shingles (H/Z) 45 Vaccines and antisera 7,003 0.01 0.00 0.00 3.58
Eslicarbazepine acetate 89 Control of epilepsy 14,352 0.01 0.00 0.00 3.56
Dapagliflozin/metformin 206 Other antidiabetic drugs 8,268 0.02 0.00 0.01 3.32
Amylmetacresol 2 Lozenges and sprays 2 1.00 0.10 0.27 3.31

Prescribing where Wolverhampton Rwt PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Gliclazide 1,757 Sulfonylureas 2,816 0.62 0.93 0.11 -2.74
Potassium permanganate 3 Oxidisers and dyes 7 0.43 0.94 0.19 -2.69
Calcium carbonate 78 Calcium supplements 95 0.82 0.96 0.05 -2.68
Permethrin 66 Parasiticidal preparations 122 0.54 0.84 0.11 -2.68
Cabergoline 32 Bromocriptine and other dopaminergic drugs 64 0.50 0.85 0.16 -2.16
Tamsulosin hydrochloride 3,541 Drugs for urinary retention 4,217 0.84 0.92 0.04 -2.13
Diazepam 1,798 Anxiolytics 2,981 0.60 0.76 0.08 -2.03
Folic acid 5,356 Drugs used in megaloblastic anaemias 12,792 0.42 0.68 0.13 -1.96
Lymecycline 170 Tetracyclines 1,903 0.09 0.24 0.08 -1.90
Gabapentin 1,701 Control of epilepsy 14,352 0.12 0.23 0.06 -1.89