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Prototype Prescribing Outlier Dashboard for Market Drayton Medical 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 Market Drayton Medical Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Dronabinol/cannabidiol 4 Skeletal muscle relaxants 103 0.04 0.00 0.01 4.07
Amiloride hydrochloride 95 Potassium-sparing diuretics and aldosterone antagonists 533 0.18 0.03 0.04 3.66
Patiromer calcium 6 Oral potassium 27 0.22 0.01 0.07 3.03
Levomepromazine hydrochloride 73 Antipsychotic drugs 1,423 0.05 0.01 0.02 2.58
Vortioxetine 153 Other antidepressant drugs 2,732 0.06 0.01 0.02 2.56
Mometasone furoate 304 Topical corticosteroids 1,709 0.18 0.07 0.04 2.52
Liraglutide 207 Other antidiabetic drugs 2,322 0.09 0.03 0.03 2.30
Quinine bisulfate 206 Antimalarials 522 0.39 0.10 0.13 2.17
Rosuvastatin calcium 893 Lipid-regulating drugs 9,883 0.09 0.04 0.02 2.13
Fluticasone furoate 726 Drugs used in nasal allergy 1,474 0.49 0.22 0.13 2.12

Prescribing where Market Drayton Medical Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Quinine sulfate 316 Antimalarials 522 0.61 0.90 0.14 -2.14
Terbinafine hydrochloride 51 Other antifungals 55 0.93 0.99 0.03 -2.08
Prednisolone 1 Copound haemorrhoidal preparations with corticosteroid 171 0.01 0.43 0.24 -1.77
Acamprosate calcium 12 Alcohol dependence 39 0.31 0.83 0.31 -1.69
Mesalazine (Systemic) 145 Aminosalicylates 334 0.43 0.65 0.15 -1.47
Beclometasone dipropionate 1,341 Corticosteroids (respiratory) 3,273 0.41 0.58 0.12 -1.45
Ibuprofen 313 Rubefacients, topical NSAIDS, capsaicin and poultice 1,384 0.23 0.52 0.20 -1.45
Mometasone furoate 209 Drugs used in nasal allergy 1,474 0.14 0.32 0.13 -1.35
Potassium chloride 21 Oral potassium 27 0.78 0.96 0.14 -1.34
Neomycin sulfate 40 Nasal preparations for infection 61 0.66 0.84 0.14 -1.32