What are the guiding principles for decision-making and adherence to GDMT for HFrEF?
The guiding principles for decision-making and adherence to GDMT for HFrEF are: 1) GDMT is the foundation of HF care, and the GDMT with the highest expected benefit should be prioritized; 2) target doses are associated with best outcomes and titration should occur even if the patient appears stable or their symptoms and/or EF improve; 3) start GDMT immediately as delayed initiation is associated with never initiating GDMT; 4) attention to clinical, social, and financial barriers to achieving GDMT should be prioritized and multidisciplinary care should be targeted to the individual patient's barriers; and 5) diligent management of volume status will reduce patient symptoms and congestion drives symptoms and hospitalizations. 