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.

An evidence-based data point is a theoretical or practical knowledge acquired through rigorous and integrated scientific methods and reasoning. The NPIS Model follows this logic in the health field (see Figure 3). It provides specific methodological and ethical recommendations for NPI for studies focusing on their mechanisms and explanatory processes (mechanistic study), their content (prototypical study), their evolution over time (observational study), their benefits and risks (interventional study), and their application and personalization modalities (implementation study).

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 choice and implementation of an NPI at a given moment in a person's prevention and care journey do not depend on the NPI Registry, nor on the mission of the NPIS. These decisions are influenced by individual health situations, preferences, the availability of professionals, the qualifications of practitioners, accessibility in a given area, and socio-cultural contexts. The art of combining NPI with each other and with other health solutions at the right time lies with professionals, expert systems, interdisciplinary organizations, and the healthcare system in place in a specific country. The NPI Registry highlights essential practices that have proven effective and continue to evolve through research and feedback analysis. The NPIS has no authority to impose a choice of NPI. Each professional is free to follow them, to pursue others, or to create new ones. The same applies to each healthcare organization.

The connection between mechanistic, interventional, and implementation studies forms the backbone of the epistemological positioning of the NPIS Model regarding the evaluation of NPI. This does not mean that an interventional study, for example, cannot explore biological mechanisms or psychosocial processes. Instead, this backbone provides coherence to the studies and structures the validation process of NPI for integration into a standardized practice framework.

NPI are protocols to be implemented with a target population, but they are merely specifications. They must be contextualized and personalized. The NPI Registry offers best practices and tips for optimal implementation. Furthermore, the NPIS recommends interdisciplinary training in health ethics for their application. The scientific society works with its partners to develop and recognize this foundational training, which could be conducted particularly in higher education institutions in collaboration with the Ministry of Health. This ethical training includes all the prerequisites of knowledge, skills, and attitudes necessary for interprofessional practice in health. Health professionals with practical experience, such as doctors, will have equivalencies.