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Prototype Prescribing Outlier Dashboard for Whittaker Lane Med 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 Whittaker Lane Med Centre is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Tiaprofenic acid 7 Non-steroidal anti-inflammatory drugs 843 0.01 0.00 0.00 13.03
Proguanil hydrochloride with atovaquone 3 Antimalarials 99 0.03 0.00 0.00 12.00
Tolnaftate 1 Antifungal preparations 208 0.00 0.00 0.00 8.53
Low protein mixes 5 Foods for special diets 26 0.19 0.01 0.02 7.62
Magnesium oxide 5 Antacids and simeticone 5 1.00 0.05 0.18 5.23
Bromfenac 1 Ocular diagnostic & peri-operative prepn & photodynamic tt 1 1.00 0.09 0.21 4.25
Fidaxomicin 1 Some other antibacterials 17 0.06 0.00 0.01 4.20
Cyproheptadine hydrochloride 6 Antihistamines 1,158 0.01 0.00 0.00 4.14
Methocarbamol 35 Skeletal muscle relaxants 64 0.55 0.08 0.15 3.08
Opicapone 16 Dopaminergic drugs used in parkinsonism 275 0.06 0.01 0.02 3.07

Prescribing where Whittaker Lane Med Centre is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Gliclazide 287 Sulfonylureas 542 0.53 0.93 0.13 -2.95
Baclofen 20 Skeletal muscle relaxants 64 0.31 0.83 0.18 -2.84
Prucalopride 0 Other drugs used in constipation 10 0.00 0.71 0.32 -2.19
    Cabergoline 3 Bromocriptine and other dopaminergic drugs 11 0.27 0.86 0.27 -2.16
    Atropine sulfate 0 Mydriatics and cycloplegics 1 0.00 0.72 0.37 -1.93
      Glucose 2 Treatment of hypoglycaemia 5 0.40 0.75 0.20 -1.76
      Ciprofloxacin 13 Quinolones 21 0.62 0.86 0.14 -1.76
      Vitamin E 0 Vitamin E 8 0.00 0.72 0.41 -1.76
        Betamethasone valerate 145 Topical corticosteroids 839 0.17 0.28 0.07 -1.64
        Salbutamol 1,634 Selective beta(2)-agonists 1,950 0.84 0.91 0.04 -1.54