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Prototype Prescribing Outlier Dashboard for Greenford Road Med.Ctr.

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 Greenford Road Med.Ctr. is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Humpapvirus(Type 6,11,16,18,31,33,45,52,58) 2 Vaccines and antisera 992 0.00 0.00 0.00 7.43
Hyoscine hydrobromide 77 Drugs used in nausea and vertigo 294 0.26 0.02 0.03 7.37
Mepyramine maleate 2 Topical local anaesthetics and antipruritics 11 0.18 0.00 0.03 6.56
Ondansetron hydrochloride 71 Drugs used in nausea and vertigo 294 0.24 0.05 0.04 5.49
Pridinol mesilate 5 Skeletal muscle relaxants 79 0.06 0.00 0.01 4.57
Phenytoin sodium 198 Control of epilepsy 2,221 0.09 0.02 0.02 4.40
Liquid paraffin 19 Tear deficiency, eye lubricant/astringent 299 0.06 0.01 0.01 4.29
Dosulepin hydrochloride 68 Tricyclic and related antidepressant drugs 523 0.13 0.02 0.03 4.21
Eflornithine monohydrate chloride 17 Shampoos and some other scalp preparations 107 0.16 0.02 0.03 4.07
Tolfenamic acid 4 Treatment of acute migraine 133 0.03 0.00 0.01 3.89

Prescribing where Greenford Road Med.Ctr. is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Pseudoephedrine hydrochloride 1 Systemic nasal decongestants 2 0.50 0.97 0.16 -2.98
Neomycin sulfate 13 Nasal preparations for infection 30 0.43 0.84 0.14 -2.95
Desogestrel 65 Oral progestogen-only contraceptives 83 0.78 0.93 0.05 -2.80
Prucalopride 0 Other drugs used in constipation 4 0.00 0.71 0.32 -2.19
    Furosemide 677 Loop diuretics 1,024 0.66 0.85 0.09 -2.16
    Rifampicin 0 Antituberculosis drugs 9 0.00 0.74 0.40 -1.88
      Baclofen 40 Skeletal muscle relaxants 79 0.51 0.83 0.18 -1.77
      Urea hydrogen peroxide 1 Removal of ear wax and other substances 4 0.25 0.83 0.33 -1.77
      Tacrolimus 15 Drugs affecting the immune response 32 0.47 0.81 0.19 -1.74
      Simvastatin 496 Lipid-regulating drugs 5,676 0.09 0.22 0.07 -1.73