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Prototype Prescribing Outlier Dashboard for Hope Farm Medical Centre

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 Hope Farm Medical Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Voriconazole 4 Triazole antifungals 122 0.03 0.00 0.01 5.68
Other vitamin A preparations 0906011 1 Vitamin A 1 1.00 0.04 0.18 5.47
Magnesium sulfate 1 Magnesium 13 0.08 0.00 0.02 3.98
Fluticasone propionate (Topical) 11 Topical corticosteroids 1,934 0.01 0.00 0.00 3.66
Prednisolone sodium phosphate 6 Corticosteroids 9 0.67 0.10 0.19 2.96
Valsartan 157 Angiotensin-II receptor antagonists 2,201 0.07 0.02 0.02 2.85
Docusate sodium 2 Removal of ear wax and other substances 2 1.00 0.15 0.32 2.64
Semaglutide 350 Other antidiabetic drugs 1,992 0.18 0.05 0.05 2.46
Co-amilozide (Amiloride hydrochloride/hydrochlorothiazide) 5 Potassium sparing diuretics and compounds 5 1.00 0.27 0.32 2.31
Nebivolol 290 Beta-adrenoceptor blocking drugs 5,431 0.05 0.02 0.02 2.20

Prescribing where Hope Farm Medical Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Urea hydrogen peroxide 0 Removal of ear wax and other substances 2 0.00 0.83 0.33 -2.52
    Vitamin A 0 Vitamin A 1 0.00 0.82 0.36 -2.28
      Co-amilofruse (Amiloride hydrochloride/frusemide) 0 Potassium sparing diuretics and compounds 5 0.00 0.69 0.33 -2.10
        Procyclidine hydrochloride 10 Antimuscarinic drugs used in parkinsonism 22 0.45 0.85 0.21 -1.89
        Hydroxychloroquine sulfate 82 Rheumatic disease suppressant drugs 768 0.11 0.37 0.16 -1.69
        Tacrolimus 0 Corticosteroids and other immunosuppressants 11 0.00 0.63 0.40 -1.58
          Fusidic acid 82 Antibacterial preparations also used systemically 155 0.53 0.75 0.14 -1.54
          Folic acid 1,112 Drugs used in megaloblastic anaemias 2,423 0.46 0.69 0.16 -1.49
          Omeprazole 2,647 Proton pump inhibitors 10,190 0.26 0.50 0.16 -1.47
          Ganciclovir 0 Antivirals 1 0.00 0.63 0.43 -1.46