History of the present illness

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.