Skip to main content

Prototype Prescribing Outlier Dashboard for Peacock Healthcare

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 Peacock Healthcare is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Indoramin 42 Drugs for urinary retention 411 0.10 0.00 0.01 11.60
Cyproterone acetate 29 Prostate cancer and gonadorelin analogues 58 0.50 0.03 0.08 5.57
Pilocarpine hydrochloride 29 Treatment of glaucoma 693 0.04 0.00 0.01 5.47
Prednisolone sodium phosphate 23 Corticosteroids 46 0.50 0.07 0.10 4.35
Salmeterol 46 Selective beta(2)-agonists 910 0.05 0.01 0.01 3.93
Oxcarbazepine 50 Control of epilepsy 1,642 0.03 0.00 0.01 3.88
Acrivastine 15 Antihistamines 614 0.02 0.00 0.01 3.77
Dipyridamole 48 Antiplatelet drugs 1,911 0.03 0.01 0.01 3.14
Other barrier preparations 5 Barrier preparations 5 1.00 0.20 0.26 3.13
Co-danthramer (Dantron/poloxamer 188) 2 Stimulant laxatives 472 0.00 0.00 0.00 3.10

Prescribing where Peacock Healthcare is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Ivermectin 2 Topical preparation for rosacea 10 0.20 0.88 0.22 -3.04
Neomycin sulfate 7 Nasal preparations for infection 16 0.44 0.84 0.14 -2.92
Calcium carbonate 7 Calcium supplements 12 0.58 0.95 0.13 -2.80
Codeine phosphate 0 Cough suppressants 3 0.00 0.74 0.33 -2.22
    Alfentanil hydrochloride 0 Opioid analgesics 3 0.00 0.82 0.38 -2.18
      Memantine hydrochloride 0 Drugs for dementia 105 0.00 0.38 0.18 -2.13
        Fluconazole 7 Triazole antifungals 12 0.58 0.85 0.13 -2.01
        Fusidic acid 14 Antibacterial preparations also used systemically 30 0.47 0.75 0.14 -1.98
        Tamsulosin hydrochloride 332 Drugs for urinary retention 411 0.81 0.92 0.06 -1.87
        Betamethasone valerate 85 Topical corticosteroids 525 0.16 0.28 0.07 -1.80