Skip to main content

Prototype Prescribing Outlier Dashboard for Delamere 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 Delamere Medical Practice is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Diflucortolone valerate 9 Topical corticosteroids 1,293 0.01 0.00 0.00 5.73
Benzydamine hydrochloride 5 Rubefacients, topical NSAIDS, capsaicin and poultice 987 0.01 0.00 0.00 5.23
Benzalkonium chloride 13 Barrier preparations 17 0.76 0.05 0.14 5.09
Lanthanum carbonate 35 Phosphate binding agents 42 0.83 0.07 0.19 3.95
Travoprost 155 Treatment of glaucoma 1,201 0.13 0.04 0.03 2.96
Balsalazide sodium 33 Aminosalicylates 288 0.11 0.02 0.03 2.94
Celecoxib 225 Non-steroidal anti-inflammatory drugs 1,646 0.14 0.03 0.04 2.91
Sodium chloride 22 Electrolytes and water 30 0.73 0.17 0.24 2.30
Canagliflozin/metformin 31 Other antidiabetic drugs 3,168 0.01 0.00 0.00 2.23
Candesartan cilexetil 1,850 Angiotensin-II receptor antagonists 2,559 0.72 0.32 0.19 2.16

Prescribing where Delamere Medical Practice is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Water for injection 8 Electrolytes and water 30 0.27 0.82 0.25 -2.25
Sodium cromoglicate 34 Other anti-inflammatory preparations 132 0.26 0.64 0.19 -2.03
Methylprednisolone acetate 2 Local corticosteroid injections 129 0.02 0.74 0.39 -1.85
Losartan potassium 463 Angiotensin-II receptor antagonists 2,559 0.18 0.50 0.19 -1.73
Ivermectin 3 Topical preparation for rosacea 6 0.50 0.88 0.22 -1.70
Timolol and bimatoprost 15 Treatment of glaucoma 1,201 0.01 0.10 0.05 -1.70
Trimethoprim 153 Sulfonamides and trimethoprim 231 0.66 0.87 0.12 -1.69
Methotrexate 114 Rheumatic disease suppressant drugs 354 0.32 0.58 0.15 -1.64
Medroxyprogesterone acetate 69 Parenteral progestogen-only contraceptives 105 0.66 0.88 0.15 -1.47
Tacrolimus 16 Drugs affecting the immune response 30 0.53 0.81 0.19 -1.41