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Prototype Prescribing Outlier Dashboard for Stockbridge Village Hc

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 Stockbridge Village Hc is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Aluminium and magnesium and oxetacaine 8 Antacids and simeticone 9 0.89 0.04 0.15 5.68
Triptorelin embonate 10 Prostate cancer and gonadorelin analogues 30 0.33 0.03 0.07 4.43
Pilocarpine hydrochloride 22 Treatment of glaucoma 648 0.03 0.00 0.01 4.33
Bromfenac 1 Ocular diagnostic & peri-operative prepn & photodynamic tt 1 1.00 0.09 0.21 4.25
Mycophenolic sodium 6 Antiproliferative immunosuppressants 56 0.11 0.01 0.03 3.94
Perindopril erbumine 2,139 Angiotensin-converting enzyme inhibitors 4,666 0.46 0.09 0.10 3.79
Podophyllotoxin 1 Preparations for warts and calluses 2 0.50 0.05 0.12 3.59
Antazoline 10 Other anti-inflammatory preparations 104 0.10 0.01 0.03 3.06
Dihydrocodeine tartrate 861 Opioid analgesics 3,878 0.22 0.06 0.05 3.05
Propafenone hydrochloride 7 Drugs for arrhythmias 40 0.18 0.02 0.05 2.94

Prescribing where Stockbridge Village Hc is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Glucose blood testing reagents 575 Diabetic diagnostic and monitoring agents 669 0.86 0.94 0.03 -2.44
Carbocisteine 452 Mucolytics 585 0.77 0.97 0.08 -2.38
Colecalciferol 2,665 Vitamin D 2,897 0.92 0.96 0.02 -1.78
Nicotine 1 Nicotine dependence 16 0.06 0.65 0.33 -1.77
Flecainide acetate 1 Drugs for arrhythmias 40 0.02 0.46 0.25 -1.74
Naftidrofuryl oxalate 0 Peripheral vasodilators and related drugs 7 0.00 0.67 0.39 -1.73
    Ramipril 2,100 Angiotensin-converting enzyme inhibitors 4,666 0.45 0.69 0.17 -1.47
    Co-amoxiclav (Amoxicillin/clavulanic acid) 42 Broad-spectrum penicillins 854 0.05 0.15 0.07 -1.43
    Macrogol 3350 548 Osmotic laxatives 960 0.57 0.71 0.10 -1.40
    Melatonin 15 Hypnotics 1,018 0.01 0.19 0.13 -1.35