Skip to main content

Prototype Prescribing Outlier Dashboard for The Mosslands 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 The Mosslands Medical Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Lormetazepam 24 Hypnotics 818 0.03 0.00 0.01 5.29
Ferric maltol 14 Oral iron 881 0.02 0.00 0.00 4.17
Colestipol hydrochloride 16 Lipid-regulating drugs 15,276 0.00 0.00 0.00 3.75
Bromfenac 5 Ocular diagnostic & peri-operative prepn & photodynamic tt 6 0.83 0.09 0.21 3.48
Minoxidil 8 Vasodilator antihypertensive drugs 8 1.00 0.12 0.26 3.44
Pioglitazone hydrochloride 641 Other antidiabetic drugs 3,040 0.21 0.04 0.05 3.36
Hydrocort sodiumphos 11 Antibacterials 112 0.10 0.01 0.03 3.26
Acenocoumarol 32 Oral anticoagulants 3,179 0.01 0.00 0.00 3.17
Acipimox 6 Lipid-regulating drugs 15,276 0.00 0.00 0.00 3.16
Piracetam 19 Essential tremor,chorea,tics and related disorders 19 1.00 0.12 0.30 2.90

Prescribing where The Mosslands Medical Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Hydralazine hydrochloride 0 Vasodilator antihypertensive drugs 8 0.00 0.85 0.28 -3.04
    Levonorgestrel 0 Emergency contraception 6 0.00 0.61 0.31 -1.97
      Zopiclone 281 Hypnotics 818 0.34 0.60 0.14 -1.88
      Tacrolimus 18 Drugs affecting the immune response 37 0.49 0.81 0.19 -1.65
      Dexamethasone 108 Otitis externa 184 0.59 0.78 0.12 -1.58
      Budesonide 184 Corticosteroids (respiratory) 4,210 0.04 0.15 0.08 -1.44
      Furosemide 1,386 Loop diuretics 1,899 0.73 0.85 0.09 -1.39
      Depigmenting agents 0 Miscellaneous topical preparations 3 0.00 0.64 0.48 -1.34
        Insulin glargine 100 Intermediate and long-acting insulins 642 0.16 0.33 0.13 -1.32
        Ketoconazole 63 Shampoos and some other scalp preparations 212 0.30 0.50 0.15 -1.31