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Prototype Prescribing Outlier Dashboard for The Medical Centre, Dr Jefferies & Partn

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 The Medical Centre, Dr Jefferies & Partn is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Valsartan/amlodipine 334 Calcium-channel blockers 5,768 0.06 0.00 0.00 29.26
Griseofulvin 1 Antifungal preparations 127 0.01 0.00 0.00 26.88
Canagliflozin/metformin 194 Other antidiabetic drugs 4,007 0.05 0.00 0.00 11.79
Erythromycin stearate 30 Macrolides 344 0.09 0.00 0.01 11.60
Capsaicin 68 Rubefacients, topical NSAIDS, capsaicin and poultice 115 0.59 0.05 0.05 10.65
Ketamine hydrochloride 7 Drugs used in nausea and vertigo 608 0.01 0.00 0.00 9.72
Indometacin 51 Non-steroidal anti-inflammatory drugs 485 0.11 0.01 0.01 7.97
Tropicamide 1 Mydriatics and cycloplegics 1 1.00 0.02 0.12 7.85
Nicotinates 1 Rubefacients, topical NSAIDS, capsaicin and poultice 115 0.01 0.00 0.00 7.73
Pentosan polysulfate sodium 6 Oral anticoagulants 2,175 0.00 0.00 0.00 6.86

Prescribing where The Medical Centre, Dr Jefferies & Partn is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ispaghula husk 18 Bulk-forming laxatives 25 0.72 0.96 0.07 -3.37
Chloramphenicol 41 Antibacterials 86 0.48 0.81 0.11 -3.06
Hypromellose 12 Tear deficiency, eye lubricant/astringent 152 0.08 0.45 0.15 -2.44
Cetirizine hydrochloride 29 Antihistamines 1,317 0.02 0.28 0.11 -2.43
Ibuprofen 7 Rubefacients, topical NSAIDS, capsaicin and poultice 115 0.06 0.52 0.20 -2.27
Co-cyprindiol (Cyprote acetate/ethinylestradiol) 5 Oral preparations for acne 7 0.71 0.98 0.13 -2.08
Morphine sulfate 105 Opioid analgesics 2,441 0.04 0.20 0.08 -2.06
Moxonidine 0 Centrally-acting antihypertensive drugs 10 0.00 0.65 0.33 -1.95
    Paracetamol 272 Non-opioid analgesics and compound preparations 1,616 0.17 0.48 0.16 -1.93
    Atropine sulfate 0 Mydriatics and cycloplegics 1 0.00 0.72 0.37 -1.93