Table 2.

Summary of Proposed Rapid Therapy Initiation Models

	Details	Timeline	Advantages	Disadvantages
Packer and McMurray27	Initiate BB and SGLT2i upfront, followed by ARNI then MRA	Four weeks to achieve initiation of GDMT	Focus on tolerability without initiating multiple medications that can induce hypotension or acute kidney injury	Coverage of therapies such as SGLT2i and ARNI may be predicated on being symptomatic on baseline HF therapies such as an ACE inhibitor, MRA, and BB
Miller et al59	Cluster phenotype-based approach; if volume overloaded, add SGLT2i; if hypertensive add ARNI/MRA; if higher heart rate, add and titrate BB and SNI	3-6 weeks of therapy initiation followed by dose titration	Based on patient clinical characteristics that may enhance tolerability	Needs multiple patient visits or touchpoints; drug coverage may predicate a sequential approach to therapy initiation
Greene et al60	Rapid initiation of low doses of all categories of foundational quadruple therapy within 1 week	Dose titration across 1 month	Enables rapid initiation of GDMT upfront, which may optimize clinical benefit	If a patient has a side effect, unclear which therapy is the culprit; drug coverage may predicate a sequential approach to therapy initiation

SNI = sinus node inhibitor; other abbreviations as in Table 1.