History of the present illness
In a medical encounter, a history of the present illness (abbreviated HPI)[1] (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).
Contents
[hide]Questions to include
Different sources include different questions to be asked while conducting an HPI, but in general they include the following (pain for example):
- Onset (sudden, or gradual)
- Location and radiation
- Severity and character/quality
- Duration, frequency and timing
- Precipitating, aggravating and palliating factors
- Progression and end
- Associated symptoms
Acronyms
Several acronyms have been developed to categorize the appropriate questions to include:
- "OPQRST".[2][3] Alternatively, "PQRST".[4][5] See also Opqrst.
- "CLEARAST"[6]
- "LIQOR AAA"[7]
- "FAR COLDER"
- "OLD CART"
- "COLDSPA"
- "COLD REARS"
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.[8][9]
See also
References
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External links
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- Jump up ↑ Adler HM (1997). "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.
- Jump up ↑ Medical Assessment
- Jump up ↑ Learning To Perform a Medical Assessment – Part 1: Quick Medical Assessment
- Jump up ↑ WEMSI - Assessment by PQRST
- Jump up ↑ Department of Medicine Home Page
- Jump up ↑ Dartmouth Medicine Magazine :: Student Notebook
- Jump up ↑ HPI (history of present illness)
- Jump up ↑ Evaluation and Management Coding and Electronic Health Records
- Jump up ↑ http://www.usc.edu/health/uscp/compliance/tm6.html#6