Skip to main content

Prototype Prescribing Outlier Dashboard for Jurassic Coast 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 Jurassic Coast PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Terazosin hydrochloride 3 Drugs for urinary retention 6,083 0.00 0.00 0.00 31.63
Fondaparinux sodium 32 Parenteral anticoagulants 120 0.27 0.01 0.02 12.94
Cyclizine lactate 321 Drugs used in nausea and vertigo 2,625 0.12 0.01 0.01 8.07
Magnesium sulfate 8 Magnesium 71 0.11 0.00 0.02 6.29
Magnesium hydroxide 9 Antacids and simeticone 12 0.75 0.04 0.12 6.02
Azelaic acid 63 Topical preparations for acne 370 0.17 0.07 0.03 3.93
Other osmotic laxative preparations 1 Osmotic laxatives 5,290 0.00 0.00 0.00 3.55
Ketotifen fumarate 44 Other anti-inflammatory preparations 527 0.08 0.02 0.02 3.50
Dulaglutide 1,223 Other antidiabetic drugs 6,049 0.20 0.06 0.04 3.22
Alprostadil 143 Drugs for erectile dysfunction 2,610 0.05 0.02 0.01 2.97

Prescribing where Jurassic Coast PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Mercaptopurine 14 Antimetabolites 107 0.13 0.81 0.27 -2.48
Alfentanil hydrochloride 0 Opioid analgesics 1 0.00 0.84 0.35 -2.36
    Ferrous fumarate 546 Oral iron 3,265 0.17 0.57 0.20 -2.04
    Cocois 11 Preparations for psoriasis 612 0.02 0.06 0.03 -1.81
    Estriol 474 Preparations for vaginal/vulval changes 2,482 0.19 0.44 0.15 -1.69
    Ulipristal acetate (Emergency Contraceptive) 1 Emergency contraception 7 0.14 0.40 0.16 -1.64
    Sodium chloride 2 Oral sodium and water 61 0.03 0.35 0.20 -1.62
    Diclofenac sodium 24 Sunscreening preparations 317 0.08 0.36 0.18 -1.61
    Melatonin 141 Hypnotics 3,470 0.04 0.18 0.09 -1.58
    Combined ethinylestradiol 30mcg 768 Combined hormonal contraceptives 1,032 0.74 0.81 0.04 -1.57