Non-pharmacological intervention

non-pharmacological intervention (NPI) is any type of healthcare intervention which is not primarily based on medication. Some examples include exercise, sleep improvement, and dietary habits.

Non-pharmacological interventions may be intended to prevent or treat (ameliorate or cure) diseases or other health-related conditions, or to improve public health. They can be educational and may involve a variety of lifestyle or environmental changes. Complex or multicomponent interventions use multiple strategies, and they often involve the participation of several types of care providers.

Non-pharmacological interventions can call on various fields of expertise, such as surgery, medical devices, rehabilitation, psychotherapy, and behavioral interventions.

Nomenclature
The term "non-pharmaceutical intervention", which is sometimes used, is inappropriate. "Pharmaceutical" refers to activities related to pharmacy practise or to the manufacture of medicinal products by pharmaceutical companies, principally emphasizing the role of the formulation of medicines in those activities, rather than their therapeutic use. "Pharmacological" relates to the study of how drugs act and how they are used in therapeutic practise. "Non-pharmacological" therefore relates to how interventions that are not based on drugs are used in therapeutic practise.

This is reflected in the definitions of "pharmacological" and "pharmaceutical" given in the Merriam-Webster Dictionary:

pharmacological [adapted from the definition of "pharmacology"]: of or relating to the properties and reactions of drugs especially with relation to their therapeutic value;

pharmaceutical: of, relating to, or engaged in pharmacy or the manufacture and sale of pharmaceuticals.

The term "non-pharmacologic intervention" is an acceptable alternate description, although Webster-Merriam says that the variant "pharmacologic" is less commonly used than "pharmacological".

Hypertension
The first line of treatment for hypertension is lifestyle changes, including dietary changes, physical exercise, and weight loss. Although these have all been recommended in scientific advisories, a Cochrane systematic review of available relevant studies found that although weigh-loss diets did reduce body weight and blood pressure, beneficial effects of those changes could not be demonstrated, owing to the small number of participants and studies, and that therefore the impact of weigh loss on mortality and morbidity is unknown. Their potential effectiveness is similar to and at times exceeds a single medication. If the blood pressure is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction. Dietary changes shown to reduce blood pressure include diets containing low amounts of sodium, the DASH diet (Dietary Approaches to Stop Hypertension), vegetarian diets, and green tea consumption. Physical exercise regimens that reduce blood pressure include isometric resistance exercise, aerobic exercise, resistance exercise, and device-guided breathing.