With the right data and the right technology, you can turn any problem into a data problem and uncover information to help address it. Health issues are no exception to this rule, and with the government being more transparent and opening up its data, the benefits of data innovation can be fully realised, helping lives for the better.
One example of this is the Health & Social Care Information Centre (HSCIC) data, the body recently renamed NHS Digital. NHS Digital’s datasets comprise a great deal of anonymised health data, including prescription data. According to NHS Digital’s website, its national datasets “define a standard set of information that is generated from care records, from any organisation or system that captures the base data. They are structured lists of individual data items, each with a clear label, definition and set of permissible values, codes and classifications. From this, secondary information is derived or compiled, which can then be used to monitor and improve services.”
Innovation through data
We worked with Antibiotic Research UK to uncover national hotspots and seasonal trends of antibiotic prescriptions. We took the same dataset and looked at allergies in the UK, identifying some very interesting insights into where the most allergy prescriptions are being dispensed. Our analysis was visualised using Tableau.
The 652 million rows of data cover every prescription given out in England over the last five years. Using an instance of EXASOL’s in-memory database, this data was analysed and trends uncovered – both nationally and by county, district, month and prescription type. By joining the data to lower layer super areas (LSOA), a high resolution map comprising 32,000 colour-coded polygons covering the UK could be generated, allowing country-wide prescribing for both antibiotics and allergy medicines to be visualised in the form of a heat map. To quickly analyse such enormous data-sets, returning answers from the data within seconds, requires the right tool and we hope the findings help to combat this serious issue.
Prosperity and allergies
The allergy research found that allergies requiring medication are increasing year-on-year across the country with a 24 per cent increase in the past five years alone. In total there are now over 14 million prescriptions a year being prescribed by GPs, with a majority being given out in June and July. Research has shown the worst ever month was July 2013, when a three-week heatwave affected the UK, leading to over 1.62 million prescriptions being issued for allergy medication (antihistamines).
The research additionally looked at the prescribing of epinephrine auto-injectors (EpiPens), the adrenaline shots that can save the lives of people suffering extreme allergic reactions, known as anaphylaxis, to antigens like bee stings, peanuts or seafood. These EpiPen prescriptions have been increasing, with an 18 per cent increase in the past five years. However, the most surprising result of the research is the geographical difference across the country, with the home counties prescribing three times the number of EpiPens per person compared to the North West. It was found that Surrey, Buckinghamshire and Hertfordshire had the highest prescribing counties compared to Manchester, Lancashire and South Yorkshire. Of the 270 districts in England, the highest prescribing rate was in the Surrey commuter-belt district of Waverley, whilst the lowest was in Oldham and Tameside. The difference here was over five times the prescribing per person in Waverley compared to Oldham.
This corroborates research that links prosperity and relative wealth with higher instances of extreme allergies. Waverley is a prosperous commuter-belt district that was top of the Halifax rural quality of life survey in 2013. It enjoys high average weekly earnings with a highly qualified workforce.
In contrast, Oldham, which has the lowest prescribing of EpiPens in the country, was most recently in March 2016 described as the most deprived town in England by the ONS.
Big Data analytics reveals that antibiotic prescriptions are rising in the most deprived areas of England
It also found that doctors prescribe 59 per cent more antibiotics in December than they do in August, despite the fact that illnesses treated by antibiotics are not seasonal. Prescriptions per head peaked in 2012 with a total of 3.8 million prescriptions to English patients, but have dropped 5.6 per cent since.
In order to visualise the health data, the prescribing dataset was combined with geographic data and plotted on a map to create the first ever choropleth heatmap of antibiotic prescribing over 32,000 geographic “Lower Level Super Output Areas” (LSOAs). The heatmap is so detailed that it is possible to single out individual surgeries overprescribing. For instance, there was a surprising hotspot in London’s wealthy Kensington & Chelsea borough, and when we zoomed in on the area, we could see that the hotspot was due to one practice used by the Chelsea pensioners and war veterans living at Royal Hospital Chelsea.
The power of data
Awareness of these issues is critical and insights can help policymakers find solutions. By analysing the readily available data with the right tools, results can be drawn that can have a significant impact on our knowledge of an issue and on decision-making that would otherwise go unnoticed, such as new links between antibiotic prescribing and deprivation and uncovering extreme allergies in the home counties. In fact, the results of the research we carried out with charity, Antibiotic Research UK, have been discussed during a parliamentary debate and acknowledged with a letter to the charity from Dame Sally Davis, the Chief Medical Officer, showing the importance of the findings. Only by using the right tools and data science, can data on this scale be analysed.
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