Skip to main content

Prototype Prescribing Outlier Dashboard for Crosby & Maghull Partnership 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 Crosby & Maghull Partnership PCN is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Irbesartan 7,819 Angiotensin-II receptor antagonists 25,663 0.30 0.08 0.06 3.97
Clomifene citrate 2 Hypothalamic & anterior pituitary hormone & antioestrogens 2 1.00 0.09 0.23 3.88
Perindopril erbumine 23,925 Angiotensin-converting enzyme inhibitors 65,827 0.36 0.09 0.08 3.53
Estradiol valandestradiol valerate with dienogest 21 Combined hormonal contraceptives 3,120 0.01 0.00 0.00 3.48
Mometasone furoate 6,946 Drugs used in nasal allergy 11,039 0.63 0.32 0.10 3.16
Enalapril maleate with diuretic 100 Angiotensin-converting enzyme inhibitors 65,827 0.00 0.00 0.00 3.07
Chlorpromazine hydrochloride 1,331 Antipsychotic drugs 20,153 0.07 0.02 0.02 3.03
Prednisolone acetate 331 Corticosteroids 706 0.47 0.14 0.11 2.95
Tazarotene 4 Preparations for psoriasis 2,165 0.00 0.00 0.00 2.85
Nepafenac 10 Ocular diagnostic & peri-operative prepn & photodynamic tt 17 0.59 0.13 0.16 2.81

Prescribing where Crosby & Maghull Partnership PCN is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Somatropin 0 Hypothalamic & anterior pituitary hormone & antioestrogens 2 0.00 0.89 0.25 -3.54
    Tacrolimus 0 Corticosteroids and other immunosuppressants 32 0.00 0.61 0.28 -2.16
      Beclometasone dipropionate 482 Drugs used in nasal allergy 11,039 0.04 0.24 0.09 -2.11
      Mercaptopurine 13 Antimetabolites 50 0.26 0.81 0.27 -2.01
      Macrogol 3350 7,176 Osmotic laxatives 12,247 0.59 0.72 0.07 -1.90
      Gentamicin sulfate 0 Aminoglycosides 2 0.00 0.74 0.41 -1.80
        Melatonin 385 Hypnotics 12,163 0.03 0.18 0.09 -1.68
        Levetiracetam 2,580 Control of epilepsy 49,825 0.05 0.09 0.03 -1.68
        Rivaroxaban 2,095 Oral anticoagulants 29,670 0.07 0.24 0.10 -1.66
        Prucalopride 257 Other drugs used in constipation 599 0.43 0.73 0.19 -1.64