Introduction
Chapter 1- Definition of Non-Pharmacological Interventions (NPIs)
“Alternative medicine”, “natural medicine”, “traditional medicine”, “integrative care”, “lifestyle solutions”, “wellness services”, “goop products” are part of our daily lives now. They invite themselves to take care of our health troubles, to cure our disease, to fight against the effects of aging, to prevent health symptoms, to be better at work, and to improve our well-being. Perhaps you have already tried reflexology, auriculotherapy, fasciatherapy, chiropractic, shiatsu? How to understand it?
1. Inventory
2. Avoiding amalgams (such as abuse of weakness, illegal exercises, usurpations of title, misinformation, loss of chance...)
3. Definition of NPIs
4. Towards the integration of NPIs into individual health pathways
Chapter 2- Reasons for the Success of NPIs
Nothing seems to have stopped the development of NPIs for the past 10 years around the world. Their success is such that not a day goes by without the publication of a study in a scientific journal, an article in the press, and hundreds of posts on social media networks. Not a week goes by without a television report or a special feature in a magazine. Not a month goes by without a congress or a specialized fair. This chapter explains the reasons for this success.
1. Epigenetics
2. Behavioral roots
3. The importance of quality of life
4. Keys to prevent and care for chronic diseases
5. A bulwark against comorbidities
6. The myth of the rationale human
7. The digital and technological revolution
8. Direct and indirect cost savings
9. Early screening and diagnosis
10. Collateral damage from chemistry and biotechnology
11. The progress of intervention research
Chapter 3– Mechanisms at Play in NPIs
In a Western world, which has made rationality one of its cardinal virtues, man seeks at all costs an explanation - and if possible the simplest explanation - for his state of health, and in the most personal way - attempts to improve it.
NPIs are no exception. Some lean for biological effects, others for psychological effects, others for systemic effects. Critics reduce them at best to placebo effects or evaluative biases, at worst to manipulations of ugly guru or greedy traders.
What are the real mechanisms? This chapter provides an overview of the main ones.
1. The natural course of the disease
2. Biological mechanisms
3. Neurological mechanisms
4. Psychological processes
5. The placebo effect
6. The nursing effect
7. Cumulative effects
8. Methodological errors
9. As long as it works
Chapter 4 –The Benefits of NPIs
"It makes me feel good," summarizes the most frequently heard opinion on NPIs. Is this sufficient justification to use them without moderation? Does satisfaction prove that non-pharmacological treatment or preventive action is effective? The answer is no; better well-being is necessary but not enough.
Trusting a paid professional or interested manufacturer is little better, due to an obvious conflict of interest.
For the past 20 years, rigorous studies have been carried out to provide evidence of the benefits of NPIs on health indicators -- not only benefits, but also risks, because any health solution carries risks.
1. Research results on NPIs
2. Assessment by category of NPIs
Chapter 5 – The Dangers of NPIs
Who can say with certainty that "natural" medicine is safe for health? How can you be sure that a food supplement generates no risk? How to certify that a psychotherapy does not hide a sectarian approach? How to avoid abuses and misuses?
Is it enough to say that a product is natural, a medicine is traditional, or a food supplement is seen on TV? How do I know if an NPI does not interfere with a medication?
Nothing can guarantee the zero risk of an NPI without prior study. However, as no standard for clinical validation of NPI exists, as no monitoring procedure is instituted, as no safety control is practiced, as no standardization of training is in force, the offer of NPIs looks like a jungle. The best meets the worst. Danger is everywhere. So, let's take a closer look.
1. Globalized disinformation
2. The dangers of natural recipes and traditional practices
3. Ecological disasters
4. Fashion effects
5. The risks of side effects
6. Inappropriate doses
7. The nocebo effect
8. The sectarian aberrations
9. Usage constraints
10. Risks
Chapter 6 – Choosing NPIs
How to choose the right NPIs? Trust our intuition? Trust a close person who has benefited? Follow media advice? Choose the offer closest to where you live? Prefer the professional who gives the most time at the best price? What care should you do? How to avoid preventive and therapeutic wandering? The use of an NPI is never completely by chance. This chapter addresses these moments that do not always lead to the best choice.
1. A testimony
2. Early detection
3. Maternity or paternity
4. Professional failure or success
5. A personal adventure
6. A book, a conference, a show
7. Announcement of an illness
8. A real meeting with a health professional
9. Pain
10. Fifties
11. The death of a close person
12. A romantic encounter or separation
13. A hospitalization
14. Palliative care
Chapter 7 – The Market for NPIs
The popularity of NPIs is growing; the offer is diversifying. They are accessible everywhere, from hospitals to city medicine, from pharmacies to websites, from hotels to shopping centers. Obscure trade names ending in “–path” or “–gist” appear on city walls. A vast and promising market for entrepreneurs and investors. A boon for communities in terms of jobs and attractiveness. A limitless area of innovation.
1. The users
2. Various professionals
3. The market
4. An offer pushed by the tourism industry and the large distribution
5. Reimbursement of NPIs
6. Research and innovation, a full-fledged market
7. Start-ups
8. Multinationals of pharmacy, digital, and food industries
9. Investors increasingly interested in and savvy with big data
10.Health: an expense and an investment
Chapter 8 – Evaluating NPIs
For thousands of years, practices resembling NPIs have been used for treatment. For hundreds of years, case studies have demonstrated the benefits for health and well-being. Observational studies have been pointing to longer lifespans for decades. In recent years, clinical studies have noted benefits on biological, psychological, and socio-economic markers.
However, authorities and learned societies remain skeptical. Collective health professionals are protesting against these practices and widening the gap with a well-established opinion. Why?
1. Overcoming controversies
2. A request for proof of effectiveness
3. Exacerbated caution from
