non-pharmacological intervention (NPI) is any type of healthcare intervention which is not primarily based on medication. Some examples include exercise,[1] sleep improvement,[2] and dietary habits.[3]
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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;[7]
pharmaceutical: of, relating to, or engaged in pharmacy or the manufacture and sale of pharmaceuticals.[8]
The term "non-pharmacologic intervention" is an acceptable alternate description, although Webster-Merriam says that the variant "pharmacologic" is less commonly used than "pharmacological".
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,[9]aCochrane 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.[10] Their potential effectiveness is similar to and at times exceeds a single medication.[11] 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,[12][13] the DASH diet (Dietary Approaches to Stop Hypertension),[14]vegetarian diets,[15] and green tea consumption.[16][17][18][19] Physical exercise regimens that reduce blood pressure include isometric resistance exercise, aerobic exercise, resistance exercise, and device-guided breathing.[20]
^Boutron I, Ravaud P (2012). "Introduction". In Boutron I, Ravaud P, Moher D (eds.). Randomized clinical trials of nonpharmacological treatments. Boca Raton: CRC Press. pp. xi–xii. ISBN9781420088021.
^He FJ, Li J, Macgregor GA (April 2013). "Effect of longer-term modest salt reduction on blood pressure". The Cochrane Database of Systematic Reviews (Systematic Review & Meta-Analysis). 30 (4): CD004937. doi:10.1002/14651858.CD004937.pub2. PMID23633321. S2CID23522004.
^Yokoyama Y, Nishimura K, Barnard ND, Takegami M, Watanabe M, Sekikawa A, Okamura T, Miyamoto Y (April 2014). "Vegetarian diets and blood pressure: a meta-analysis". JAMA Internal Medicine. 174 (4): 577–87. doi:10.1001/jamainternmed.2013.14547. PMID24566947.
^Khalesi S, Sun J, Buys N, Jamshidi A, Nikbakht-Nasrabadi E, Khosravi-Boroujeni H (September 2014). "Green tea catechins and blood pressure: a systematic review and meta-analysis of randomised controlled trials". European Journal of Nutrition (Systematic Review and Meta-Analysis). 53 (6): 1299–311. doi:10.1007/s00394-014-0720-1. hdl:10018/1239907. PMID24861099. S2CID206969226.