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Prototype Prescribing Outlier Dashboard for Carnforth And Milnthorpe 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 Carnforth And Milnthorpe PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Amphotericin 1 Polyene antifungals 183 0.01 0.00 0.00 13.10
Nimodipine 10 Calcium-channel blockers 20,237 0.00 0.00 0.00 7.17
Sodium fusidate 74 Antibacterial preparations also used systemically 395 0.19 0.02 0.03 6.08
Iron and folic acid 47 Oral iron 2,581 0.02 0.00 0.00 5.43
Cyanocobalamin 5,473 Drugs used in megaloblastic anaemias 8,541 0.64 0.12 0.10 5.34
Prednisolone sodium metasulphobenzoate 37 Corticosteroids 49 0.76 0.15 0.14 4.47
Darifenacin hydrobromide 324 Drugs for urinary frequency enuresis and incontinence 2,670 0.12 0.01 0.03 4.24
Methenamine hippurate 537 Urinary-tract infections 2,367 0.23 0.04 0.05 3.75
Fludroxycortide 53 Topical corticosteroids 3,806 0.01 0.00 0.00 3.46
Tenoxicam 2 Non-steroidal anti-inflammatory drugs 4,724 0.00 0.00 0.00 3.44

Prescribing where Carnforth And Milnthorpe PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Nystatin 182 Polyene antifungals 183 0.99 1.00 0.00 -13.10
Nitrofurantoin 1,830 Urinary-tract infections 2,367 0.77 0.96 0.05 -3.75
Procyclidine hydrochloride 32 Antimuscarinic drugs used in parkinsonism 60 0.53 0.85 0.11 -2.95
Budesonide 10 Corticosteroids 49 0.20 0.72 0.18 -2.94
Mercaptopurine 15 Antimetabolites 231 0.06 0.81 0.27 -2.72
Folic acid 2,874 Drugs used in megaloblastic anaemias 8,541 0.34 0.68 0.13 -2.57
Diclofenac diethyl 32 Rubefacients, topical NSAIDS, capsaicin and poultice 2,100 0.02 0.30 0.13 -2.15
Co-codamol (Codeine phosphate/paracetamol) 2,354 Non-opioid analgesics and compound preparations 12,105 0.19 0.44 0.12 -2.01
Fusidic acid 228 Antibacterial preparations also used systemically 395 0.58 0.75 0.09 -1.94
Hydroxocobalamin 194 Drugs used in megaloblastic anaemias 8,541 0.02 0.19 0.09 -1.84