The term NPI has been used by scientists working in the health field since 1975. However, it is not the only term; other similar terms are used synonymously, especially in PubMed. There are ten English terms to describe non-pharmacological processes and twenty-eight to describe methods of operation. An exhaustive inventory of NPI on a scientific article search engine is currently impossible due to the variety of terms researchers use, each with distinct meanings: rehabilitation intervention, psychosocial intervention, mental intervention, cognitive intervention, psychological intervention, behavioral intervention, psychosomatic intervention, nutrition intervention, dietary intervention, food intervention, physical intervention, body intervention, exercise intervention, manual intervention, salutogenic intervention, natural intervention, self-help intervention, nursing intervention, therapy intervention, care intervention, disease management intervention, multimodal intervention...

A search on PubMed from August 15, 2024, indicates 55,689 articles citing the term "non-pharmacological" or its equivalent up to 2023. While these figures do not challenge the trend, they are likely underestimated due to the database's focus on health products rather than services, biological treatments over psychosocial ones, studies on North American populations, and journals published by North American organizations. This aligns with an official U.S. government site managed by the National Center for Biotechnology Information and hosted by the National Library of Medicine, part of the National Institutes of Health (NIH).

A search on PubMed from August 15, 2024, also reveals 11,642 articles citing the term "non-pharmacological intervention" or its equivalent up to 2023. Both curves demonstrate an increase since 2000, with a notable acceleration since 2010.

The French National Authority for Health has been encouraging the use of the term NPI in health since 2011.

Immaterial practices of prevention and care have existed since ancient times. However, the diversification of practices, the multiplication of professions at the intersection of prevention, care, and social assistance, and the globalization of information systems have leveled these services and obscured them at a time when medicine has made significant advances in the early detection and diagnosis of health issues. The interdisciplinary and multisectoral approach of the NPIS generates a value chain, from the design of practices to their implementation, regulation, and financing.

Innovative economic model initiatives are emerging worldwide, including fee-for-service, bundled payments, social economy provisions, offers promoting sustainable development, e-health economy, human innovation bundles, and long-term economy (World Economic Forum, 2024). The NPIS Prospective Pole, led by Michel Noguès, documents these initiatives in books (Noguès, 2022; Noguès, 2024). The NPIS Forums invite all innovators to share their experiences.

The NPIS has outlined a roadmap from 2021 to 2030 aligned with the strategies of European and international health institutions. To this end, it has initiated discussions with the European Public Health Association (EUPHA), involved in health service innovation, the European Centre for Disease Prevention and Control (ECDC), which is planning to create a registry, the European Commission, which aims to promote "health, nutrition, mental health, and psychosocial support to communities," and WHO Europe, which intends to identify the "most effective health interventions" by 2030. The NPIS submitted several European projects in 2024.

The NPIS is also engaging with WHO, which has advocated for "self-care interventions" since 2022, included NPI in its Global Action Plan for Mental Health published in 2022, and identified "the most effective and feasible interventions in a national context" in a report published in 2021. Additionally, it is collaborating with other international organizations such as UNESCO, which has promoted "specific health and well-being education interventions" since 2016, UNICEF, which has advocated for sharing "effective health interventions" since 2016 and developing "primary healthcare" since 2018, the UN, which has called for "accelerating essential health services" since 2023, and the Coalition of Partnerships for Universal Health Coverage and Global Health, advocating for "people-centered, comprehensive, and integrated services" since 2021.

Thus, an ecosystem for NPI, from research to practice through training and delivery, is being constructed, with NPIS actively participating. It involves all stakeholders, both academic and non-academic, to create a true value chain benefiting personalized and precision medicine based on science, sustainable health, and equitable longevity. With over 2.1 billion people aged over 60 by 2050, multistakeholder collaborations will be the foundation of a sustainable and equitable longevity economy.

This is why forums on NPI have been organized since 2024 in France and Europe, called NPIS Forum. An international summit titled NPIS Summit takes place every year in October, and regional events called NPIS Satellite gather professionals and users around a health theme.

PSYCHOSOCIAL DOMINANCE

Psychotherapies:

• Cognitive Stimulation Therapy for memory strategies in Alzheimer’s disease in 14 sessions by a psychologist in a healthcare facility, health center, or private practice.
• Mindfulness Based Stress Reduction (MBSR-BC) program against anxiety during cancer treatments in 8 group sessions by a clinical psychologist, psychiatrist, or physician in an oncology department, a patient association, a private practice, a health center, or a healthcare facility.
• Acceptance and Commitment Therapy for chronic pain in 9 group sessions by a clinical psychologist or psychiatrist in a healthcare facility, health center, or private practice.
• Cognitive Behavioral Therapy for Insomnia (CBT-I) in 6-8 individual sessions, either remote or in-person, by a neuropsychologist, clinical psychologist, psychiatrist, or neurologist in a healthcare facility, health center, or private practice.
• Now I Can Do Heights program using virtual reality to treat acrophobia (fear of heights) by a clinical psychologist or psychiatrist in a private practice or health center.

Health Prevention Programs:

• Living Well with COPD therapeutic education program against symptoms and exacerbations of COPD over 2 months with 4 sessions, in-person or remote, by a nurse, physician, or pharmacist in a healthcare facility, health center, or private practice.
• CHESS Method (Chronic Headache Education and Self-management) for migraine self-management by a nurse or physician in a healthcare facility, health center, or private practice.
• MyFriend Youth Program for preventing anxiety and depression among students aged 12 to 15 years, 10 sessions by a school psychologist or school nurse in an educational institution.
• Spiegel Hypnotherapy Method specialized in smoking cessation in 3 sessions by a psychologist, nurse, physician, or hypnotherapist in a private practice, healthcare facility, health center, or private practice.
• Cognitive Behavioral Therapy for Depression (CBT-d) by a clinical psychologist or psychiatrist in a healthcare facility, health center, or private practice.

CORPOREAL DOMINANCE

Physiotherapy Protocols:

• McKenzie Method for back pain by a physiotherapist in a healthcare facility, health center, or private practice.
• Pelvic Floor Muscle Training (PFMT) program by a midwife or physiotherapist in a health center or private practice.
• Rehabilitation program following hip prosthesis in 6 to 10 sessions by a physiotherapist in a healthcare facility, health center, or private practice.

Adapted Physical Activity Programs:

• Dance Therapy for Parkinson’s Disease addressing psychological symptoms of Parkinson’s by a physical activity instructor in a healthcare facility, health center, or private practice.
• Re-exercise program at ventilatory threshold against dyspnea caused by COPD by a physical activity instructor or physiotherapist in a healthcare facility, health center, or private practice.
• Anti-fatigue APA program during treatments for breast, prostate, or colon cancer by a physical activity instructor in a healthcare facility, health center, or private practice.

Thermal Treatments:

• Specialized thermal cure for gonarthrosis by a physiotherapist or thermal agent in a thermal facility.

NUTRITIONAL DOMINANCE

• Gluten-free diet for celiac disease by a dietitian in a healthcare facility, health center, or private practice.
• FODMAP diet for gastrointestinal disorders by a dietitian in a healthcare facility, health center, or private practice.

The term non-pharmacological intervention (NPI) was not chosen by the scientific society NPIS but has become necessary. It has been used by scientists since 1975. Various authorities and agencies have adopted it, including the World Health Organization since 2003, the French National Authority for Health since 2011, the National Solidarity Fund for Autonomy since 2014, the Ministry of Health since 2018, the High Council for Public Health since 2019, the European Centre for Disease Prevention and Control since 2020, the General Inspectorate of Social Affairs since 2022, the Economic, Social and Environmental Council since 2023, and Health Insurance since 2024. Many national and supranational scientific societies use the term NPI in their recommendations. These health solutions are often "squeezed" between health products and public health measures, despite efforts by professionals to raise awareness and recognition of them. They represent an underestimated area of intangible services situated between goods (e.g., medications, medical devices) and general public health recommendations (e.g., dietary rules, hygiene measures, environmental actions).

They can be lost in compilations of health solutions that mix health promotion actions with targeted programs or confuse methods for identifying a health problem with methods for resolving it. The challenge is to improve the traceability of practices for continuous enhancement of their quality, safety, implementation, and training. These practices can be easily shared from one country to another. The term NPI does not imply "anti-medication" or "alternative medicine" (parallel medicine). Instead, it draws from the rigor of the globally standardized drug validation process to establish good scientific and clinical practices. Over time, we believe that the abbreviation NPI will come to be more widely recognized than its full title, similar to WHO, IBM, SEAT, and many others.

Registers of non-pharmacological practices with imprecise criteria and boundaries.
Catalogs compile various health practices among which NPI may be submerged. Some target the general population, while others are more specific. The selection criteria are heterogeneous, and objectives and practical modalities vary widely. Three examples include two from the United States (EBCCP and Mindtools) and one from France (Capitalisation Santé).