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Prototype Prescribing Outlier Dashboard for Sedgley, Coseley & Gornal 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 Sedgley, Coseley & Gornal PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Mizolastine 191 Antihistamines 6,261 0.03 0.00 0.00 14.01
Calcium polystyrene sulfonate 34 Oral potassium 83 0.41 0.01 0.04 10.21
Pethidine hydrochloride 68 Opioid analgesics 11,472 0.01 0.00 0.00 5.84
Ins degludec/liraglutide 161 Other antidiabetic drugs 6,986 0.02 0.00 0.00 5.63
Insulin glargine/lixisenatide 17 Intermediate and long-acting insulins 3,504 0.00 0.00 0.00 5.33
Salbutamol 101 Compound bronchodilator preparations 739 0.14 0.01 0.02 5.31
Naratriptan hydrochloride 285 Treatment of acute migraine 1,828 0.16 0.04 0.02 4.54
Aclidinium bromide 688 Antimuscarinic bronchodilators 2,706 0.25 0.04 0.05 4.52
Sucroferric oxyhydroxide 8 Phosphate binding agents 115 0.07 0.00 0.02 4.25
Reboxetine 77 Other antidepressant drugs 10,285 0.01 0.00 0.00 3.95

Prescribing where Sedgley, Coseley & Gornal PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Potassium chloride 49 Oral potassium 83 0.59 0.97 0.07 -5.23
Amlodipine 11,444 Calcium-channel blockers 23,307 0.49 0.75 0.08 -3.14
Memantine hydrochloride 49 Drugs for dementia 1,023 0.05 0.38 0.11 -2.95
Allopurinol 3,315 Gout and cytotoxic induced hyperiuicaemia 3,976 0.83 0.90 0.03 -2.47
Flecainide acetate 72 Drugs for arrhythmias 579 0.12 0.46 0.15 -2.24
Lymecycline 308 Tetracyclines 4,841 0.06 0.24 0.08 -2.22
Mercaptopurine 10 Antimetabolites 44 0.23 0.81 0.27 -2.13
Atorvastatin 22,419 Lipid-regulating drugs 40,795 0.55 0.67 0.06 -2.06
Olanzapine 790 Antipsychotic drugs 6,859 0.12 0.22 0.05 -2.03
Ivermectin 17 Topical preparation for rosacea 26 0.65 0.89 0.11 -2.02