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Prototype Prescribing Outlier Dashboard for Wf Network Of Independent Practices 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 Wf Network Of Independent Practices PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Cefuroxime axetil 8 Cephalosporins 62 0.13 0.00 0.01 12.70
Tetracosactide 3 Hypothalamic & anterior pituitary hormone & antioestrogens 6 0.50 0.01 0.07 6.60
Inclisiran 1 Lipid-regulating drugs 30,413 0.00 0.00 0.00 4.65
Pethidine hydrochloride 46 Opioid analgesics 10,064 0.00 0.00 0.00 4.42
Salicylic acid 9 Preparations for psoriasis 532 0.02 0.00 0.00 4.35
Spironolactone with loop diuretics 1 Potassium sparing diuretics and compounds 6 0.17 0.01 0.04 4.15
Oxytetracycline 323 Tetracyclines 1,976 0.16 0.05 0.03 3.95
Ciprofloxacin 52 Otitis externa 724 0.07 0.01 0.02 3.73
Doxepin hydrochloride 9 Topical local anaesthetics and antipruritics 89 0.10 0.01 0.03 3.32
Loratadine 1,108 Antihistamines 4,402 0.25 0.12 0.04 2.99

Prescribing where Wf Network Of Independent Practices PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Somatropin 2 Hypothalamic & anterior pituitary hormone & antioestrogens 6 0.33 0.89 0.25 -2.22
Atorvastatin 16,618 Lipid-regulating drugs 30,413 0.55 0.67 0.06 -2.12
Erythromycin 5 Topical preparations for acne 505 0.01 0.12 0.05 -2.10
Terbinafine hydrochloride 97 Other antifungals 101 0.96 0.99 0.02 -2.02
Amlodipine 10,857 Calcium-channel blockers 18,193 0.60 0.75 0.08 -1.86
Memantine hydrochloride 122 Drugs for dementia 677 0.18 0.38 0.11 -1.78
Zopiclone 2,021 Hypnotics 4,416 0.46 0.61 0.09 -1.73
Cefalexin 54 Cephalosporins 62 0.87 0.96 0.05 -1.70
Tiotropium bromide 741 Antimuscarinic bronchodilators 1,596 0.46 0.71 0.14 -1.69
Fusidic acid 6 Antibacterials 700 0.01 0.08 0.04 -1.69