Use of a questionnaire to improve occupational and environmental history taking in primary care physicians

New patient charts were reviewed before and after the introduction of a sel f-administered questionnaire, designed to elicit occupational and environme ntal (OE) information from patients. The Occupational Health Risk Assessmen t questionnaire (OHRA) was expected to prompt primary care physicians to ma ke further inquiries into OE health issues. Chart reviews determined the am ount and type of information detailed in the primary care physicians' notes . Twenty-three percent of completed OHRAs indicated a job-related health pr oblem. Despite a high prevalence of self-reported work-related symptoms and exposures, the mean number of notations regarding OE exposures was less th an one item per patient chart. A comparison of mean OE notations per chart before versus after introduction of the OHRA indicated a decline in notatio ns after introduction of the OHRA (1.03 vs 0.72, P = 0.02). We detail the t ype of OE issues that patients presented to a primary care practice and the resulting information contained in primary care providers' notes. Suggesti ons are made to improve a self-administered patient questionnaire to better diagnose prioritize, and formulate treatment plans related to OE issues.