Skip to main content

Prototype Prescribing Outlier Dashboard for Kimbolton Medical Centre

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 Kimbolton Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Cefuroxime axetil 5 Cephalosporins 34 0.15 0.00 0.02 6.51
Ins degludec/liraglutide 24 Other antidiabetic drugs 959 0.03 0.00 0.00 4.77
Terbutaline sulphate 107 Selective beta(2)-agonists 1,296 0.08 0.02 0.01 4.35
Liraglutide 126 Other antidiabetic drugs 959 0.13 0.03 0.03 3.90
Etonogestrel 15 Parenteral progestogen-only contraceptives 21 0.71 0.12 0.15 3.87
Haemophilus influenzae B/meningococcal C 3 Vaccines and antisera 1,903 0.00 0.00 0.00 3.78
Combined ethinylestradiol 35mcg 42 Combined hormonal contraceptives 221 0.19 0.05 0.04 3.78
Glycerol 34 Stimulant laxatives 243 0.14 0.04 0.03 3.61
Mometasone furoate 656 Drugs used in nasal allergy 943 0.70 0.32 0.13 2.85
Rupatadine fumarate 4 Antihistamines 1,535 0.00 0.00 0.00 2.58

Prescribing where Kimbolton Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Medroxyprogesterone acetate 6 Parenteral progestogen-only contraceptives 21 0.29 0.88 0.15 -3.87
Combined ethinylestradiol 30mcg 142 Combined hormonal contraceptives 221 0.64 0.81 0.07 -2.33
Coal tar 3 Shampoos and some other scalp preparations 31 0.10 0.40 0.15 -2.02
Methylprednisolone acetate 0 Local corticosteroid injections 20 0.00 0.74 0.39 -1.89
    Ramipril 1,708 Angiotensin-converting enzyme inhibitors 4,465 0.38 0.69 0.17 -1.88
    Ispaghula husk 74 Bulk-forming laxatives 89 0.83 0.96 0.07 -1.82
    Estriol 35 Preparations for vaginal/vulval changes 384 0.09 0.45 0.20 -1.77
    Amoxicillin 391 Broad-spectrum penicillins 532 0.73 0.85 0.07 -1.75
    Naftidrofuryl oxalate 0 Peripheral vasodilators and related drugs 9 0.00 0.67 0.39 -1.73
      Apixaban 321 Oral anticoagulants 1,953 0.16 0.41 0.14 -1.73