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Background and Objective: According to Swedish legislation, when discharged from inpatient care the medical record must be updated with a follow-up plan of drug treatment. It is of value to have a standardized method for measuring the occurrence of what we call a “complete follow-up plan”. To our knowledge, no such tool has been developed. The aim of the study was to examine how accurate a prototype for a new tool is at determining whether a complete follow-up plan exists, as well as how reliable the tool is between different assessors. 

Design: A retrospective chart review was conducted on a randomly selected study population. For assessment of a complete follow-up plan, a prototype for a new tool was used by two master students in clinical pharmacy and three experts (two senior clinical pharmacist and a physician specializing in geriatrics). To test the hypothesis that there is a systematic difference between users of the tool in assessing discharges as complete in terms of follow-up of drug changes, McNemar’s test was used. 

Setting: Internal medicine wards at Uppsala University Hospital.

Main outcome measures: Cohen’s kappa was calculated to obtain a measure of inter-rater reliability. Sensitivity, specificity, positive and negative predictive values were calculated as a measure of criterion-related validity by comparing the students’ consensus assessments with an expert group’s, with the latter considered to be true. 

Result: A total of 102 patients were included. χ2 between students’ assessments and between students and experts was calculated 0.143 and 1.80, respectively. Since χ2 <3.84, the difference is not statistically significant, and the null hypothesis applies in both cases; no systematic difference in assessing follow-up plans as complete can be demonstrated. Consistency between students’ assessments and between students and expert group resulted in Cohen’s kappa value of 0.45 and 0.51 respectively, which is considered moderate agreement. The sensitivity was calculated to be 0.64, the specificity 0.89, positive and negative predicted value 0.88 and 0.67, respectively. 

Conclusion: The tool has the capacity to decide whether complete follow-up plan exists with moderate consistency, but further development is recommended.