History of the present illness

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Overview

In a medical encounter, a history of the present illness (HPI) (termed history of presenting complaint (HPC) in the UK) refers to a detailed interview prompted by the chief complaint or presenting symptom (for example, pain).

Questions to include

Different sources include different questions to be asked while conducting a HPI, but in general they include the following:

• onset
• location and radiation
• severity and character/quality
• duration and timing
• precipitating and palliating factors
• progression

Acronyms

Several acronyms have been developed to categorize the appropriate questions to include:

• "OPQRST". Alternatively, "PQRST". See also Opqrst.
• "CLEARAST"
• "LIQOR AAA"
• "FAR COLDER"
• "OLD CART"

Medicare definitions

The Centers for Medicare and Medicaid Services has published criteria for what constitutes a reimbursable HPI. A "brief HPI" constitutes one to three of the following elements:

• location
• quality
• severity
• duration
• timing
• context
• modifying factors
• associated signs & symptoms

A "extended HPI" includes four or more of these elements.

See also

• medical record
• medical history
• pain scale

References

• Adler H. "The history of the present illness as treatment: who's listening, and why does it matter?". J Am Board Fam Pract. 10 (1): 28–35. PMID 9018660.

External links

• Overview at usc.edu
• Overview at medicine.ucsd.edu
• Overview at nur.utexas.edu
• Template:LoyolaMedEd
• Overview at medinfo.ufl.edu