Skip to main content

Prototype Prescribing Outlier Dashboard for Staffordshire & Stoke On Trent STP

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 STPs. From this we can calculate the “z-score”, which is a measure of how many standard deviations a given STP 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 STP's chemical:subparagraph ratios is provided, with this STP'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 Staffordshire & Stoke On Trent STP is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Idebenone 7 Other eye preparations 102 0.07 0.00 0.01 6.26
Ibuprofen lysine 265 Non-steroidal anti-inflammatory drugs 122,651 0.00 0.00 0.00 6.01
Dolutegravir 2 HIV infection 14 0.14 0.01 0.03 5.18
Calcitriol 2,472 Vitamin D 356,749 0.01 0.00 0.00 5.02
Econazole nitrate 15 Antifungal preparations 14,597 0.00 0.00 0.00 4.83
Asenapine 52 Drugs used for mania and hypomania 10,890 0.00 0.00 0.00 4.75
Flurazepam hydrochloride 1 Hypnotics 83,674 0.00 0.00 0.00 4.69
Mercaptamine hydrochloride 15 Tear deficiency, eye lubricant/astringent 46,752 0.00 0.00 0.00 4.58
Pilocarpine nitrate 674 Treatment of glaucoma 129,974 0.01 0.00 0.00 4.51
Acetylcysteine 12,417 Mucolytics 50,935 0.24 0.02 0.05 4.16

Prescribing where Staffordshire & Stoke On Trent STP is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Carbomer 95 Other eye preparations 102 0.93 1.00 0.01 -6.26
Carbocisteine 37,858 Mucolytics 50,935 0.74 0.97 0.05 -4.19
Desmopressin acetate 3,313 Posterior pituitary hormones and antagonists 3,333 0.99 1.00 0.00 -3.60
Aciclovir 967 Antiviral preparations 971 1.00 1.00 0.00 -2.72
Gentamicin sulfate 4 Aminoglycosides 30 0.13 0.73 0.26 -2.24
Filgrastim 0 Drugs used in neutropenia 9 0.00 0.81 0.39 -2.09
    Lithium carbonate 3,925 Drugs used for mania and hypomania 10,890 0.36 0.61 0.12 -2.08
    Insulin aspart 26,556 Short-acting insulins 39,319 0.68 0.79 0.06 -2.04
    Sodium citrate (Rectal) 529 Osmotic laxatives 135,303 0.00 0.01 0.00 -1.97
    Ticagrelor 2,253 Antiplatelet drugs 401,040 0.01 0.02 0.01 -1.89