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Prototype Prescribing Outlier Dashboard for Tessa Jowell Gp 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 Tessa Jowell Gp Surgery is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Chlohexidine gluconate (Emollient) 3 Emollients 228 0.01 0.00 0.00 8.05
Rasagiline mesilate 113 Dopaminergic drugs used in parkinsonism 301 0.38 0.05 0.05 6.90
Isotretinoin 49 Oral preparations for acne 59 0.83 0.02 0.13 6.42
Rufinamide 15 Control of epilepsy 2,185 0.01 0.00 0.00 4.21
Eplerenone 422 Potassium-sparing diuretics and aldosterone antagonists 551 0.77 0.25 0.13 3.85
Captopril 36 Angiotensin-converting enzyme inhibitors 3,474 0.01 0.00 0.00 3.85
Beclometasone dipropionate (Systemic) 1 Corticosteroids 2 0.50 0.04 0.13 3.65
Ciprofloxain/dexameth 52 Otitis externa 184 0.28 0.05 0.06 3.55
Olopatadine 74 Other anti-inflammatory preparations 104 0.71 0.18 0.15 3.44
Emulsifying wax 25 Emollients 228 0.11 0.01 0.03 3.35

Prescribing where Tessa Jowell Gp Surgery is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Co-cyprindiol (Cyprote acetate/ethinylestradiol) 10 Oral preparations for acne 59 0.17 0.98 0.13 -6.42
Spironolactone 124 Potassium-sparing diuretics and aldosterone antagonists 551 0.23 0.72 0.14 -3.61
Sodium cromoglicate 19 Other anti-inflammatory preparations 104 0.18 0.64 0.19 -2.43
Terbinafine hydrochloride 56 Other antifungals 61 0.92 0.99 0.03 -2.38
Simvastatin 401 Lipid-regulating drugs 7,021 0.06 0.22 0.07 -2.14
Furosemide 834 Loop diuretics 1,238 0.67 0.85 0.09 -2.02
Finasteride 159 Male sex hormones and antagonists 269 0.59 0.82 0.11 -2.00
Cetirizine hydrochloride 70 Antihistamines 859 0.08 0.28 0.11 -1.87
Prednisolone 272 Use of corticosteroids 349 0.78 0.89 0.06 -1.86
Oral rehydration salts 5 Oral sodium and water 29 0.17 0.71 0.29 -1.83