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Prototype Prescribing Outlier Dashboard for Ashville Medical Centre Pms Practice

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 Practices. From this we can calculate the “z-score”, which is a measure of how many standard deviations a given Practice 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 Practice's chemical:subparagraph ratios is provided, with this Practice'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 Ashville Medical Centre Pms Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Dronedarone hydrochloride 31 Drugs for arrhythmias 56 0.55 0.02 0.06 8.62
Diazoxide 12 Treatment of hypoglycaemia 76 0.16 0.00 0.03 4.72
Darifenacin hydrobromide 317 Drugs for urinary frequency enuresis and incontinence 1,842 0.17 0.01 0.03 4.59
Buspirone hydrochloride 228 Anxiolytics 922 0.25 0.03 0.06 3.36
Dicycloverine hydrochloride 50 Antispasmodic and other drugs altering gut motility 1,032 0.05 0.01 0.01 3.28
Fluoxetine hydrochloride 2,417 Selective serotonin re-uptake inhibitors 7,945 0.30 0.16 0.05 2.95
Eslicarbazepine acetate 67 Control of epilepsy 7,389 0.01 0.00 0.00 2.94
Linagliptin/metformin 87 Other antidiabetic drugs 2,173 0.04 0.00 0.01 2.92
Zonisamide 206 Control of epilepsy 7,389 0.03 0.01 0.01 2.72
Indometacin 62 Non-steroidal anti-inflammatory drugs 1,520 0.04 0.01 0.01 2.62

Prescribing where Ashville Medical Centre Pms Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Losartan potassium 379 Angiotensin-II receptor antagonists 2,475 0.15 0.50 0.19 -1.87
Brinzolamide 25 Treatment of glaucoma 1,192 0.02 0.09 0.04 -1.86
Vitamin E 0 Vitamin E 8 0.00 0.72 0.41 -1.76
    Progesterone 11 Progestogens and progesterone receptor modulators 110 0.10 0.53 0.27 -1.59
    Diclofenac diethyl 13 Rubefacients, topical NSAIDS, capsaicin and poultice 718 0.02 0.29 0.18 -1.57
    Fluorouracil (Sunscreen) 0 Sunscreening preparations 14 0.00 0.45 0.29 -1.55
      Emollient bath and shower preparations 24 Emollient bath and shower preparations 78 0.31 0.63 0.21 -1.52
      Amiodarone hydrochloride 6 Drugs for arrhythmias 56 0.11 0.48 0.25 -1.46
      Amlodipine 3,140 Calcium-channel blockers 5,279 0.59 0.76 0.11 -1.43
      Bimatoprost 33 Treatment of glaucoma 1,192 0.03 0.11 0.06 -1.40