I appreciate this analysis. My last job was working as a provider for frail older adults with multiple chronic conditions in primary care. Every time they went to the hospital, the cardiologist there would try to put them on GDMT. We would try, but they would become hypotensive, pass out, and fall. GDMT absolutely needs more nuance for a frail older population, and hospital cardiologists need to look at their patients (maybe even call the PCP) rather than blindly following algorithms.
I appreciate this analysis. My last job was working as a provider for frail older adults with multiple chronic conditions in primary care. Every time they went to the hospital, the cardiologist there would try to put them on GDMT. We would try, but they would become hypotensive, pass out, and fall. GDMT absolutely needs more nuance for a frail older population, and hospital cardiologists need to look at their patients (maybe even call the PCP) rather than blindly following algorithms.