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Prototype Prescribing Outlier Dashboard for Sellindge Surgery

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 Sellindge Surgery is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Diflucortolone valerate 6 Topical corticosteroids 461 0.01 0.00 0.00 10.96
Tafluprost and timolol 34 Treatment of glaucoma 685 0.05 0.00 0.01 5.94
Heparinoid 86 Rubefacients, topical NSAIDS, capsaicin and poultice 318 0.27 0.03 0.04 5.78
Cyclizine lactate 57 Drugs used in nausea and vertigo 554 0.10 0.01 0.02 5.40
Dosulepin hydrochloride 138 Tricyclic and related antidepressant drugs 867 0.16 0.02 0.03 5.37
Ciprofloxacin/fluocinolone 3 Otitis externa 71 0.04 0.00 0.01 4.94
Triamterene with thiazides 4 Potassium sparing diuretics and compounds 76 0.05 0.00 0.01 4.41
Salmeterol 60 Selective beta(2)-agonists 1,224 0.05 0.01 0.01 3.78
Dexamethasone phosphate 6 Use of corticosteroids 421 0.01 0.00 0.00 3.55
Iron and folic acid 15 Oral iron 670 0.02 0.00 0.01 3.37

Prescribing where Sellindge Surgery is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Simple 1 Expectorant and demulcent cough preparations 2 0.50 0.96 0.17 -2.72
Other emollient preparations 111 Emollients 154 0.72 0.89 0.07 -2.48
Amitriptyline hydrochloride 578 Tricyclic and related antidepressant drugs 867 0.67 0.84 0.08 -2.30
Furosemide 548 Loop diuretics 819 0.67 0.85 0.09 -2.08
Atropine sulfate 0 Mydriatics and cycloplegics 8 0.00 0.72 0.37 -1.93
    Other multivitamin preparations 11 Multivitamin preparations 26 0.42 0.82 0.21 -1.93
    Methylprednisolone acetate 0 Local corticosteroid injections 24 0.00 0.74 0.39 -1.89
      Sertraline hydrochloride 748 Selective serotonin re-uptake inhibitors 2,504 0.30 0.46 0.09 -1.84
      Prednisolone 2 Copound haemorrhoidal preparations with corticosteroid 45 0.04 0.43 0.24 -1.61
      Carbomer 940/980 13 Tear deficiency, eye lubricant/astringent 129 0.10 0.34 0.15 -1.61