Acceptability and Feasibility of a Multicomponent Intervention to Improve Acute Myocardial Infarction Care in Northern Tanzania: the MIMIC Pilot Trial.

Abstract

BACKGROUND: The Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC) was developed to increase uptake of evidence-based care for acute myocardial infarction in Tanzania. MIMIC consists of five components: triage cards, pocket cards, an online training module, patient educational pamphlets, and clinical champions. Our aim was to determine the acceptability and feasibility of this intervention among emergency department (ED) providers in Tanzania. METHODS: During a one-year pilot of the MIMIC intervention at the Kilimanjaro Christian Medical Centre in northern Tanzania, ED physicians and nurses were approached and invited to complete a survey eliciting their perspectives on MIMIC. The survey included the four-item Acceptability of Intervention Measurement (AIM) and four-item Feasibility of Intervention Measurement (FIM) tools. Mean AIM and FIM scores were generated by assigning scores of 1-5 for each response (1= strongly disagree, 2 = disagree, 3= neutral, 4= agree, 5= strongly agree), and dividing by four. RESULTS: Sixty-four participants were enrolled, including 27 (42%) physicians and 37 (58%) nurses. The mean AIM score was 4.82 (sd = 0.31) out of a maximum possible score of 5. The mean FIM score was 4.61 (sd 0.47). Of participants, 63 (98%) reported using the pocket cards and 54 (84%) reported completing the training module, which took a mean of 16.5 (sd 13.3) minutes to complete. Of 36 nurses who worked in triage, all (100%) reported using the MIMIC triage cards. CONCLUSIONS: The MIMIC intervention is highly acceptable and feasible in a northern Tanzanian ED. Use of a co-design approach in the development of the MIMIC intervention likely increased the acceptability and feasibility the intervention to staff. Additional study is needed to determine the effectiveness of this intervention on clinical care processes and patient outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT04563546 ; registered on September 21 st , 2020; https://clinicaltrials.gov/study/NCT04563546.