History of the present illness
Encyclopedia
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).
Several acronyms have been developed to categorize the appropriate questions to include.
The Centers for Medicare and Medicaid Services
has published criteria for what constitutes a reimbursable HPI. A "brief HPI" constitutes one to three of these elements. A "extended HPI" includes four or more of these elements.
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
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
Chief complaint
The Chief Complaint formally known as CC in the medical field, or termed Presenting Complaint in the UK, is a concise statement describing the symptom, problem, condition, diagnosis, physician recommended return, or other factor that is the reason for a medicalencounter...
or presenting symptom (for example, pain).
Questions to include
Different sources include different questions to be asked while conducting an HPI.Several acronyms have been developed to categorize the appropriate questions to include.
The Centers for Medicare and Medicaid Services
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
has published criteria for what constitutes a reimbursable HPI. A "brief HPI" constitutes one to three of these elements. A "extended HPI" includes four or more of these elements.
| CMS | "OPQRST Opqrst "PQRST" is sometimes used instead.The term "OPQRST-AAA" adds "aggravating/alleviating factors", "associated symptoms", and "attributions/adaptations".-Meaning:The parts of the mnemonic are:... " or "PQRST" |
"CLEARAST" | "LIQOR AAA" | "SCHOLAR" ("S" = Symptoms) |
|---|---|---|---|---|
| location | "R": Region and Radiation | "L": Location | "L": Location | "L:" Location |
| quality | "Q": Quality of the pain | "C": Character | "Q": Quality | "C:" Characteristics |
| "R": Radiation | "R": Radiation | see above | ||
| severity | "S": Severity | "S": Severity | "I": Intensity | see above |
| duration | "O": Onset | "T": Time frame | "O": Onset | "O:" Onset "H:" History |
| timing | "T": Time | see above | see above | see above |
| context | ||||
| modifying factors | "P": Provocation or Palliation | "E": Exacerbation | "A": Aggravating factors | "A:" Aggravating factors |
| "A": Alleviation | "A": Alleviating factors | "R:" Remitting factors | ||
| associated signs & symptoms | "A": associated symptoms | "A": Associated symptoms | see above |