Skip to main content

Prototype Prescribing Outlier Dashboard for Shropshire And Telford And Wrekin 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 Shropshire And Telford And Wrekin STP is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Soft soap 1 Cationic surfactants and soaps 135 0.01 0.00 0.00 6.19
Dextromethorphan hydrobrom compound prepartions 3 Expectorant and demulcent cough preparations 137 0.02 0.00 0.00 5.96
Betaine anhydrous 3 Drugs used in metabolic disorders 3 1.00 0.06 0.16 5.80
Paliperidone 150 Antipsychotic drugs 44,595 0.00 0.00 0.00 5.75
Erdosteine 658 Mucolytics 18,545 0.04 0.00 0.01 5.74
Gentamicin sulfate 3 Antibacterial preparations also used systemically 4,418 0.00 0.00 0.00 5.44
Iron carboxymaltose 1 Parenteral iron 1 1.00 0.04 0.18 5.25
Darunavir 1 HIV infection 10 0.10 0.01 0.02 5.15
Dibrompropamidine isetionate 12 Preparations for minor cuts and abrasions 65 0.18 0.02 0.03 5.04
Ciprofloxacin/fluocinolone 160 Otitis externa 10,108 0.02 0.00 0.00 4.75

Prescribing where Shropshire And Telford And Wrekin STP is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Alcohol 0 Alcohols and saline 13 0.00 0.87 0.23 -3.84
    Pseudoephedrine hydrochloride 48 Systemic nasal decongestants 57 0.84 0.96 0.04 -3.05
    Iron dextran 0 Parenteral iron 1 0.00 0.88 0.29 -3.01
      Pilocarpine hydrochloride 101 Treatment of dry mouth 399 0.25 0.57 0.13 -2.49
      Finasteride 14,414 Male sex hormones and antagonists 19,591 0.74 0.84 0.04 -2.38
      Combined ethinylestradiol 35mcg 442 Combined hormonal contraceptives 14,360 0.03 0.06 0.01 -2.15
      Tamsulosin hydrochloride 44,459 Drugs for urinary retention 50,880 0.87 0.92 0.02 -2.08
      Benzocaine 1 Lozenges and sprays 10 0.10 0.42 0.15 -2.07
      Clarithromycin 4,489 Macrolides 10,927 0.41 0.59 0.09 -2.06
      Glucagon 273 Treatment of hypoglycaemia 2,286 0.12 0.21 0.05 -2.02