History of the present illness

Not to be confused with Past medical history.

In a medical encounter, a history of the present illness (abbreviated 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 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". Alternatively, "PQRST". See also Opqrst.
• "CLEARAST"
• "LIQOR AAA"
• "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.

See also

• Medical record
• Medical history
• Pain scale

External links

• Overview at medicine.ucsd.edu
• Overview at medinfo.ufl.edu