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Prototype Prescribing Outlier Dashboard for The Andover Health Centre Medical Pract

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 Andover Health Centre Medical Pract is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Buprenorph hydrochloride/naloxone hydrochloride 9 Opioid dependence 12 0.75 0.01 0.07 10.60
Tapentadol hydrochloride 243 Opioid analgesics 2,153 0.11 0.01 0.02 6.05
Denosumab 56 Bisphosphonates and other drugs 659 0.08 0.01 0.02 4.06
Ins degludec/liraglutide 27 Other antidiabetic drugs 1,287 0.02 0.00 0.00 3.95
Other eczema preparations 13 Preparations for eczema 16 0.81 0.05 0.20 3.75
Testosterone enantate 7 Male sex hormones and antagonists 285 0.02 0.00 0.01 3.73
Magnesium citrate 15 Magnesium 18 0.83 0.07 0.21 3.61
Testosterone undecanoate 40 Male sex hormones and antagonists 285 0.14 0.03 0.03 3.57
Nicotine bitartrate 2 Nicotine dependence 27 0.07 0.00 0.03 2.49
Indoramin 20 Drugs for urinary retention 824 0.02 0.00 0.01 2.48

Prescribing where The Andover Health Centre Medical Pract is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Gamolenic acid 3 Preparations for eczema 16 0.19 0.90 0.30 -2.41
Isosorbide mononitrate 191 Nitrates 397 0.48 0.72 0.11 -2.24
Somatropin 1 Hypothalamic & anterior pituitary hormone & antioestrogens 3 0.33 0.90 0.28 -2.04
Acamprosate calcium 2 Alcohol dependence 10 0.20 0.83 0.31 -2.04
Oral rehydration salts 4 Oral sodium and water 30 0.13 0.71 0.29 -1.96
Spironolactone 179 Potassium-sparing diuretics and aldosterone antagonists 378 0.47 0.72 0.14 -1.78
Levothyroxine sodium 2,904 Thyroid hormones 2,923 0.99 1.00 0.00 -1.71
Losartan potassium 411 Angiotensin-II receptor antagonists 2,162 0.19 0.50 0.19 -1.68
Aspirin 1,448 Antiplatelet drugs 2,631 0.55 0.65 0.06 -1.64
Finasteride 182 Male sex hormones and antagonists 285 0.64 0.82 0.11 -1.59