[LUM#6] Non-drug interventions: a new way of caring

[LUM Magazine] - Published on September 12, 2017 in Science-Society

A physical activity program to treat depression? Hypnosis to stop smoking? Non-medication interventions (NMIs) are gaining ground, both in the scientific community and among healthcare professionals. A revolution in the making?

Formerly known as "médecines douces" (alternative medicines), "remèdes de grand-mère" (grandmother's remedies) or "thérapies alternatives" (alternative therapies), these vague terms have a way of annoying Grégory Ninot. For this researcher at the Epsylon laboratory in Montpellier, it's time to put an end to the vagueness that has long surrounded therapeutic solutions whose efficacy is sometimes known, but never proven. " This was empirical knowledge, transmitted from master to pupil without any real scientific evaluation or understanding of the underlying mechanisms. This led to beliefs and fads taking precedence over genuine, science-based health practices," explains Grégory Ninot.

Risks and dangers

The stakes are high, because these NMIs, which cover practices as varied as meditation, nutritional therapies, thermalism, health-connected objects, physical activity programs and preventive actions, represent a hope: that of less unilateral, less invasive therapeutics, better adapted to each individual's specific needs. Beware, however, warns this specialist: "NMIs are rarely alternatives but rather complements to biological treatments" (Conférence grand public, Médecines naturelles, médecines complémentaires, médecines alternatives: De quoi parl-t-on?). And examples of aberrations are legion. "In cancer in particular, there's a lot of talk about the significant healing effects of dietary supplements, but serious clinical studies are lacking. Some people suggest practices such as combat sports to prevent recurrence, again without proof...". Caution is therefore called for, even for seemingly harmless practices: essential oils, for example, which can prove toxic if a precise dosage is not respected(Non-medicated intervention INM: a concept for ambiguities on alternative and complementary medicine, in Hegel, 2018).

The result: fragile patients abused, and blunted credibility. Hence the urgent need to separate the wheat from the chaff. This is precisely the aim of the CEPS platform in Montpellier, a unique structure in France financed by the State-Region plan contract and supported by the Montpellier Metropolis. Its mission: to contribute to the emergence of a consensual paradigm for evaluating and monitoring NMIs. "We need to do what was done 50 years ago for drugs, by creating a consensual clinical validation process. Today, 19 procedures coexist in NMIs, making it impossible to compare their benefits, risks and cost-effectiveness," explains Grégory Ninot(Ontologie des interventions non médicamenteuses, in Revue d'épidémiologie et de santé publique, 2018).

From care to prevention

Proving the effectiveness of NMIs would be the first step towards their reimbursement. Because the stakes are also high financially: diets and adapted physical activity programs are all NMIs that help prevent the onset of chronic diseases that are particularly costly for the community. These include diabetes, obesity, cancer and cardiovascular disease, all of which are on the rise and now account for 63% of deaths worldwide.

Key words : LUM#6, LUM Magazine, Medicine, Health, Company