Evidence map›Paper›PMID 33431380›Full record

Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2021

Matching depression management to severity prognosis in primary care: results of the Target-D randomised controlled trial.

Susan Fletcher, Patty Chondros, Konstancja Densley, Elizabeth Murray, Christopher Dowrick, Amy Coe, Kelsey Hegarty, Sandra Davidson, Caroline Wachtler, Cathrine Mihalopoulos and 4 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

  1. Trial
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  5. Observational
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  10. Matching depression management to severity prognosis in primary care: remaining questions.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024
    Article
  11. Article
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  15. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Susan FletcherDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
Patty ChondrosDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
Konstancja DensleyDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
Elizabeth MurrayDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia; professor of eHealth and primary care, Research Department of Primary Care and Population Health, University College London, London, UK.
Christopher DowrickDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia; professor of primary medical care, Department of Health Services Research, University of Liverpool, Liverpool, UK.
Amy CoeDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
Kelsey HegartyDepartment of General Practice, Melbourne Medical School, University of Melbourne; director, Centre for Family Violence Prevention, The Royal Women's Hospital, Melbourne, Australia.
Sandra DavidsonDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
Caroline WachtlerDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia; family medicine resident, Department of General Practice and Primary Care, Karolinska Institutet, Solna, Sweden.
Cathrine MihalopoulosDeakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia.
Yong Yi LeeDeakin Health Economics, Institute for Health Transformation, Deakin University, Geelong; honorary fellow, School of Public Health, University of Queensland, Brisbane; health economist, Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia.
Mary Lou ChattertonDeakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia.
Victoria J PalmerDepartment of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
Jane GunnFaculty of Medicine, Dentistry and Health Sciences, University of Melbourne; chair of primary care research, Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMental health treatment rates are increasing, but the burden of disease has not reduced. Tools to support efficient resource distribution are required.

aimTo investigate whether a person-centred e-health (Target-D) platform matching depression care to symptom severity prognosis can improve depressive symptoms relative to usual care. DESIGN AND

settingStratified individually randomised controlled trial in 14 general practices in Melbourne, Australia, from April 2016 to February 2019. In total, 1868 participants aged 18-65 years who had current depressive symptoms; internet access; no recent change to antidepressant; no current antipsychotic medication; and no current psychological therapy were randomised (1:1) via computer-generated allocation to intervention or usual care.

methodThe intervention was an e-health platform accessed in the GP waiting room, comprising symptom feedback, priority-setting, and prognosis-matched management options (online self-help, online guided psychological therapy, or nurse-led collaborative care). Management options were flexible, neither participants nor staff were blinded, and there were no substantive protocol deviations. The primary outcome was depressive symptom severity (9-item Patient Health Questionnaire [PHQ-9]) at 3 months.

resultsIn intention to treat analysis, estimated between- arm difference in mean PHQ-9 scores at 3 months was -0.88 (95% confidence interval [CI] = -1.45 to -0.31) favouring the intervention, and -0.59 at 12 months (95% CI = -1.18 to 0.01); standardised effect sizes of -0.16 (95% CI = -0.26 to -0.05) and -0.10 (95% CI = -0.21 to 0.002), respectively. No serious adverse events were reported.

conclusionMatching management to prognosis using a person-centred e-health platform improves depressive symptoms at 3 months compared to usual care and could feasibly be implemented at scale. Scope exists to enhance the uptake of management options.

Indexed as

DepressionPrimary Health CareAdolescentAdultAgedAustraliaHumansMiddle AgedPrognosisQuality of LifeTreatment OutcomeYoung Adultclinical prediction rulegeneral practicemental healthprimary health carerandomised controlled trial

Identifiers

PMID33431380
PMCPMC7846356

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.