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Prototype Prescribing Outlier Dashboard for Quinton And Harborne 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 Quinton And Harborne PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Strontium ranelate 7 Bisphosphonates and other drugs 1,677 0.00 0.00 0.00 4.82
Magnesium citrate 10 Magnesium 16 0.62 0.07 0.15 3.71
Low protein pastas 33 Foods for special diets 599 0.06 0.01 0.01 3.60
Ciclesonide 100 Corticosteroids (respiratory) 7,161 0.01 0.00 0.00 3.42
Perindopril arginine with diuretic 51 Angiotensin-converting enzyme inhibitors 11,446 0.00 0.00 0.00 3.05
Glycopyrronium bromide 527 Antimuscarinic bronchodilators 1,692 0.31 0.06 0.08 2.99
Low protein cooking aids 5 Foods for special diets 599 0.01 0.00 0.00 2.95
Semaglutide 677 Other antidiabetic drugs 4,101 0.17 0.05 0.04 2.85
Acrivastine 47 Antihistamines 4,287 0.01 0.00 0.00 2.62
Rutosides 7 Peripheral vasodilators and related drugs 19 0.37 0.06 0.12 2.61

Prescribing where Quinton And Harborne PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Levonorgestrel 8 Emergency contraception 34 0.24 0.60 0.16 -2.27
Medroxyprogesterone acetate 123 Parenteral progestogen-only contraceptives 190 0.65 0.86 0.10 -2.06
Ganciclovir 0 Antivirals 3 0.00 0.65 0.33 -2.00
    Magnesium aspartate 0 Magnesium 16 0.00 0.50 0.27 -1.88
      Estradiol with progestogen 471 Oestrogens and Hormone Replacement Therapy 1,848 0.25 0.38 0.07 -1.79
      Calcipotriol 408 Preparations for psoriasis 514 0.79 0.87 0.04 -1.77
      Bimatoprost 112 Treatment of glaucoma 3,790 0.03 0.11 0.05 -1.66
      Tiotropium bromide 802 Antimuscarinic bronchodilators 1,692 0.47 0.71 0.14 -1.63
      Ferrous fumarate 492 Oral iron 1,890 0.26 0.57 0.20 -1.57
      Timolol and bimatoprost 143 Treatment of glaucoma 3,790 0.04 0.10 0.04 -1.56