Skip to main content

Prototype Prescribing Outlier Dashboard for Celadine Health & Metrocare 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 Celadine Health & Metrocare PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Sulfadiazine 5 Sulfonamides and trimethoprim 515 0.01 0.00 0.00 9.19
Co-simalcite (Simeticone/hydrotalcite) 3 Antacids and simeticone 47 0.06 0.00 0.01 6.20
Valproic acid 58 Control of epilepsy 11,200 0.01 0.00 0.00 5.76
Glycopyrronium bromide 79 Antispasmodic and other drugs altering gut motility 929 0.09 0.02 0.01 4.90
Rabies 2 Vaccines and antisera 10,419 0.00 0.00 0.00 4.72
Arnica montana 3 Rubefacients, topical NSAIDS, capsaicin and poultice 2,381 0.00 0.00 0.00 4.41
Lithium citrate 14 Drugs used for mania and hypomania 285 0.05 0.01 0.01 4.35
Meningococcal B vaccine 4 Vaccines and antisera 10,419 0.00 0.00 0.00 4.03
Liquid paraffin 88 Emollient bath and shower preparations 481 0.18 0.03 0.04 3.95
Co-danthramer (Dantron/poloxamer 188) 8 Stimulant laxatives 2,783 0.00 0.00 0.00 3.89

Prescribing where Celadine Health & Metrocare PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ispaghula husk 299 Bulk-forming laxatives 347 0.86 0.96 0.04 -2.30
Glyceryl trinitrate 332 Nitrates 2,224 0.15 0.26 0.07 -1.71
Gabapentin 1,463 Control of epilepsy 11,200 0.13 0.23 0.06 -1.69
Theophylline 134 Theophylline 170 0.79 0.93 0.08 -1.62
Beclometdiprop/formoterol/glycopyrronium 120 Selective beta(2)-agonists 7,786 0.02 0.06 0.03 -1.58
Famotidine 111 H2-Receptor antagonists 170 0.65 0.83 0.11 -1.53
Ropinirole hydrochloride 158 Dopaminergic drugs used in parkinsonism 2,393 0.07 0.15 0.06 -1.48
Olanzapine 524 Antipsychotic drugs 3,558 0.15 0.22 0.05 -1.43
Ketorolac trometamol 11 Ocular diagnostic & peri-operative prepn & photodynamic tt 151 0.07 0.42 0.26 -1.34
Light liquid paraffin 78 Emollient bath and shower preparations 481 0.16 0.33 0.13 -1.33