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Preserving Identity and Planning for Advance Care (PIPAC): preliminary outcomes from a patient-centered intervention for individuals with mild dementia
Hilgeman MM, Allen RS, Snow AL, Durkin DW, DeCoster J, Burgio LD.. Aging & mental health, 2013-12-20
Topic: Risk, prevention and care in population studies
Objectives The purpose of this pilot study was to conduct limited-efficacy testing of the newly developed Preserving Identity and Planning for Advance Care (PIPAC) intervention on self-reported and proxy-reported emotional and health-related outcomes of individuals in the early stages of dementia. Method A two-group comparison design was implemented. Blocked randomization was used to assign individuals with mild dementia and a family contact to either (1) the four-session, multi-component intervention group focused on reminiscence and future planning or (2) the minimal support phone contact comparison group. Of the 19 enrolled dyads, 18completed post-treatment assessments (i.e. 10 intervention and 8 comparison group). Individuals with dementia were M=82.8 (SD=6.46) years old; 31.6% were men and 68.4% were women. Participants were predominantly white/Caucasian (n=18, 94.7%) with one black/African-American (5.3%). Results Analyses of covariance controlling for baseline differences revealed clinically meaningful differences (with medium to large effect sizes) between groups at post-treatment for depressive symptoms, quality of life, health-related quality of life indicators, and decisional conflict. Individuals in the intervention group were also observed to exhibit higher levels of coping. Feasibility data collected from participants and interventionists were encouraging. Conclusion Emotion-focused, patient-centered interventions like PIPAC hold promise for advancing treatment options in the early and mild stages of dementia. A full-scale, randomized clinical trial of this intervention is warranted to determine both short-term and long-term impacts on clinical outcomes including improved depressive symptomatology, quality of life, and health-related factors that impact daily functioning in social environments.
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APA 7th
Hilgeman, M. M., Allen, R. S., Snow, A. L., Durkin, D. W., DeCoster, J., & Burgio, L. D. (2014). Preserving Identity and Planning for Advance Care (PIPAC): preliminary outcomes from a patient-centered intervention for individuals with mild dementia. Aging & mental health. https://doi.org/10.1080/13607863.2013.868403
Vancouver
Hilgeman MM, Allen RS, Snow AL, Durkin DW, DeCoster J, Burgio LD. Preserving Identity and Planning for Advance Care (PIPAC): preliminary outcomes from a patient-centered intervention for individuals with mild dementia. Aging & mental health. 2014. doi:10.1080/13607863.2013.868403. PMID: 24359036.
BibTeX
@article{hilgeman2014-24359036,
author = {Hilgeman, M. M. and Allen, R. S. and Snow, A. L. and Durkin, D. W. and DeCoster, J. and Burgio, L. D.},
title = {{Preserving Identity and Planning for Advance Care (PIPAC): preliminary outcomes from a patient-centered intervention for individuals with mild dementia}},
journal = {Aging \& mental health},
year = {2014},
doi = {10.1080/13607863.2013.868403},
pmid = {24359036},
url = {https://doi.org/10.1080/13607863.2013.868403}
}
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Key findings
- Results Analyses of covariance controlling for baseline differences revealed clinically meaningful differences (with medium to large effect sizes) between groups at post-treatment for depressive symptoms, quality of life, health-related quality of life indicators, and decisional conflict.
Why it matters
This pilot randomly assigned 19 pairs (a person with mild dementia plus a family member) to either a four-session program of reminiscence and future planning (PIPAC) or minimal phone contact. At the end of the program, the 10 program pairs showed "clinically meaningful differences (with medium to large effect sizes)" compared with the 8 phone-contact pairs in depressive symptoms, quality of life and decisional conflict. With so few people, nearly all of them white, and no longer-term follow-up, this shows the approach is worth testing properly. It does not show that it works.
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Study details
- Participants18
- Effect size31.6%; 68.4%; 94.7%
- Evidence strengthHigh
How this study scored 61/100
Published in a peer-reviewed journal, and it is a randomised controlled trial.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Aging & mental health) |
| Journal's citation record | 2 / 4 | Aging & Mental Health: journal h-index 153 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2014 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 18 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 4 / 7 | Cited 77 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.5 citations a year over 14 year(s) since 2014 |
| Impact for its field and year | 2 / 6 | Cited 2.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 2 / 4 | Cited 17 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author L. D. Burgio: h-index 17 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Virginia: institution h-index 1,118 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 24359036) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 61 / 100 | — |
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