[Non-pharmacological medical interventions based on evidence. An exploratory study]

Non-pharmacological interventions prescribed are a frequent component of the medical practice mainly in ambulatory settings and also require a sound scientific basis. Our purpose was to estimate the proportion of evidence based non-pharmacological medical interventions in the clinical practice of an ambulatory setting.

Medical interventions present in 150 medical records were review from a systematic sample. The evidence for the interventions was searched in Medline (1986-1997). They were classified according the presence of supporting experimental evidence for each of the intervention.

We found 92 different primary diagnosis. A 25% were non-pharmacological interventions and the rest mostly pharmacological. A 80% of the non-pharmacological were evidence based. The most frequent non-pharmacological interventions were those related to cardiovascular disease (diet, physical exercise, etc.), followed by upper respiratory tract infections (hydration), low back pain (physical therapy, rest or both), constipation (diet, exercise) and gastro-enteritis (diet). Only hydration or the respiratory tract lacks experimental based evidence.

There are experimental evidence for the non-pharmacological interventions revised, easily accessible but unevenly distributed and with effectiveness issues remaining controversial.