[Non-pharmacological interventions: A new paradigm and opportunities for internists]

The notion of non-pharmacological interventions (NPI) has been used by healthcare researchers since 1975, and is cited in numerous reports by French, European and international healthcare authorities, such as the WHO since 2003 and the HAS since 2011. However, it was only recently that a collaborative initiative of consensus was launched to address the lack of consensus on how to define and evaluate these health practices, amplified by the media controversy surrounding these practices during the COVID-19 episode. Indeed, in 2021, the launch of a collaborative and open research program responding to international scientific expectations in the healthcare field and to the specificities of these immaterial, personalized and targeted healthcare solutions has finally been initiated. The first part of this article, intended for specialists in internal medicine, describes the consensus-building work carried out under the guidance of a multidisciplinary committee, with the support of Inserm and the logistics of the international Non-Pharmacological Intervention Society (NPIS). Over a period of three years, this work, involving more than 1000 participants, established a definition, a characterization and an evaluative framework including 77 ethical and methodological recommendations for these practices. This NPIS Model framework has received the support of 30 French scientific and medical societies, two European societies and three French health authorities. The second part of the article presents the collaborative tools that have emerged from this work. Finally, the third part of the article looks at the implications of NPI for research and practice in the field of internal medicine.