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Prototype Prescribing Outlier Dashboard for Dr S Phillips And Dr M Patel 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 Dr S Phillips And Dr M Patel Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Rufinamide 25 Control of epilepsy 964 0.03 0.00 0.00 16.58
Perindopril arginine with diuretic 50 Angiotensin-converting enzyme inhibitors 1,780 0.03 0.00 0.00 12.12
Doxycycline monohydrate 5 Tetracyclines 76 0.07 0.00 0.01 9.08
Escitalopram 356 Selective serotonin re-uptake inhibitors 1,268 0.28 0.04 0.04 6.90
Hydrocortisone sodium succinate 4 Use of corticosteroids 215 0.02 0.00 0.00 6.64
Phosphates (Rectal) 30 Osmotic laxatives 467 0.06 0.01 0.01 6.37
Cefadroxil 1 Cephalosporins 21 0.05 0.00 0.01 5.60
Phased formulations of ethinylestradiol 12 Combined hormonal contraceptives 138 0.09 0.01 0.02 4.97
Co-proxamol (Dextropropoxyphene hydrochloride/paracetamol) 6 Non-opioid analgesics and compound preparations 1,541 0.00 0.00 0.00 3.73
Atomoxetine hydrochloride 17 CNS Stimulants and drugs used for ADHD 36 0.47 0.08 0.11 3.61

Prescribing where Dr S Phillips And Dr M Patel Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Quinine sulfate 90 Antimalarials 198 0.45 0.90 0.14 -3.25
Pizotifen malate 0 Prophylaxis of migraine 10 0.00 0.63 0.26 -2.46
    Other emollient preparations 237 Emollients 327 0.72 0.89 0.07 -2.42
    Budesonide 0 Corticosteroids 4 0.00 0.71 0.32 -2.21
      Desogestrel 66 Oral progestogen-only contraceptives 81 0.81 0.93 0.05 -2.21
      Carbocisteine 41 Mucolytics 51 0.80 0.97 0.08 -2.01
      Gliclazide 303 Sulfonylureas 450 0.67 0.93 0.13 -1.88
      Benzydamine hydrochloride 10 Drugs for oral ulceration and inflammation 18 0.56 0.84 0.16 -1.80
      Naftidrofuryl oxalate 0 Peripheral vasodilators and related drugs 1 0.00 0.67 0.39 -1.73
        Dexamethasone 45 Otitis externa 78 0.58 0.78 0.12 -1.66