Why do clinicians not prescribe quadruple medical therapy for heart failure with reduced ejection fraction?

The article discusses the underutilization of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF). It highlights the findings of the CHAMP-HF registry, which revealed that many eligible patients did not receive GDMT. The article explores various reasons for this, including patient out-of-pocket costs, poor tolerability, patient preference, and clinical inertia. The authors present the results of the HELP-HF registry, which examined the reasons for non-prescription or non-titration of GDMT. However, the study faced limitations due to missing data and the subjective nature of reasons provided. The article emphasizes the need for definitive data to understand the barriers to GDMT utilization and improve patient care. [Extracted from the article]