The Target-D Trial
As the single largest cause of disability burden in Australia, depression results in lost employee productivity of over $2.7 billion per year. Depression is mainly managed in general practice. Using data from our successful diamond longitudinal cohort study we have developed the diamond clinical prediction tool (CPT) for use in primary care.
Using this tool the trial is testing the hypothesis that a stratified approach to the primary care management of depression will result in clinical and economic benefits compared to usual general practice care. The primary aim is to test whether stratifying patients into low, medium and high risk groups using the diamond CPT and offering targeted depression treatment will reduce depressive symptoms at 3 months compared to usual care. The secondary aims are to test differences between the intervention and usual care arms within each risk group in terms of physical and social functional impairment, quality of life, health service use and cost-efficacy at 3 and 12 months.
Professor Jane Gunn, Lead Investigator, Department of General Practice (University of Melbourne)
Dr Patty Chondros, Department of General Practice (University of Melbourne)
Dr Sandra Davidson, Department of General Practice (University of Melbourne)
Ms Amy Coe, Senior Research Assistant, Department of General Practice (University of Melbourne)
Ms Konstancja Densley, Data Manager, Department of General Practice (University of Melbourne)
Dr Susie Fletcher, Research Fellow, Department of General Practice (University of Melbourne)
Associate Professor Catherine Mihalopoulos, Deakin Health Economics (Deakin University)
Associate Professor Kelsey Hegarty, Department of General Practice (University of Melbourne)
Dr Alishia Williams, Social and Behavioural Science (University of Utrecht, Netherlands)
Professor Leon Sterling, School of Science, Engineering and Technology (Swinburne University of Technology)
Dr Antonette Mendoza, Department of Computing and Information Systems (University of Melbourne)
Professor Christopher Dowrick, Institute of Psychology, Health and Society (University of Liverpool, UK)
Professor Elizabeth Murray, Research Department of Primary Care and Population Health, eHealth Unit (University College London, UK)
Professor Frances Griffiths, Warwick Medical School (University of Warwick, UK)
Professor Gavin Andrews, School of Psychiatry, (University of New South Wales)
Dr Gilles Ambresin, Department of Psychiatry (University of Lausanne, Switzerland)
Dr Victoria Palmer, Department of General Practice (University of Melbourne)
The Target-D Trial is funded by an NHMRC Project Grant (2014)
Please click on the tab below for a brief summary of findings.
The full scientific report of the trial outcomes are currently in press and will be made available by mid-2020.
Selected publications and presentations
Fletcher S, Chondros P, Densley K, Murray E, Dowrick C, Coe A, Hegarty K, Davidson S, Wachtler C, Mihalopoulos C, Lee YY, Chatterton ML, Palmer V, Gunn J. Matching depression management to severity prognosis in primary care: results of the Target-D randomised controlled trial. BJGP. 2021. 71 (703): e85-e94 DOI: https://doi.org/10.3399/BJGP.2020.0783
Gunn J, Wachtler C, Fletcher S, Davidson S, Mihalopoulos C, Palmer V, Hegarty K, Coe A, Murray E, Dowrick C. Target-D: a stratified individually randomized controlled trial of the diamond clinical prediction tool to triage and target treatment for depressive symptoms in general practice: study protocol for a randomized controlled trial. Trials. 2017 DOI: 10.1186/s13063-017-2089-y
Using a clinical prediction tool to help tailor depression care: The Target-D randomized controlled trial.(Poster). Primary Health Care Research & Information Service (PHCRIS) Conference. 8–9 June 2016, Canberra, Australia.
Target-D: Protocol for a randomised trial of a clinical prediction tool for targeting depression care. (Oral). Society for Academic Primary Care (SAPC) Annual Scientific Meeting. 8 July, 2016, Dublin, Ireland.
Participatory design for development of a triage tool: the Target-D mobile application (Oral). North American Primary Care Research Group (NAPCRG) Annual Meeting. 23 – 28 October 2015, Cancun, Mexico.
Target-D: A Randomised Trial of a Clinical Prediction Tool for Targeting Depression Care (Poster). North American Primary Care Research Group (NAPCRG) Annual Meeting. 21 – 25 November 2014, Cancun, Mexico.
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