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    Rebecca Sudore, MD

    TitleAssociate Professor
    SchoolUCSF School of Medicine
    Address4150 Clement St
    San Francisco CA 94121
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      Collapse Biography 
      Collapse Education and Training
      University of California, San Francisco Residency School of Medicine
      University of California, San FranciscoM.D.School of Medicine1998
      Collapse Awards and Honors
      Society of General Internal Medicine2012Junior Investigator of the Year
      Hartford Foundation Center of Excellence2010Faculty Scholar
      Bay Area Symposium on Clinical Research2009Best Research Poster
      RWJ2009 - 2012Physician Faculty Scholar
      American Geriatrics Society2009Junior Investigator Award
      AAHPM2009 - 2012Leadership Fellow
      Bay Area Symposium on Clinical Research2007Best Junior Faculty Research Project

      Collapse Overview 
      Collapse Overview
      Dr. Rebecca Sudore is an Associate Professor In-Residence in the Division of Geriatrics. She is dedicated to helping vulnerable older adults and their families make informed medical decisions, especially for advance care planning and at the end-of-life.

      Rebecca’s inspiration for her research and her expertise in tailoring health education materials to patients with limited health literacy derives from her work with vulnerable populations at homeless clinics; San Francisco General Hospital; the Geriatrics, Palliative Care and Hospice Services at the San Francisco VA; and the adult literacy program through the San Francisco Library.

      Since 2002, Rebecca has provided primary care to vulnerable, older Veterans in the Geriatrics clinic at the San Francisco VA Medical Center. Many of her patients have dementia or are seriously ill. Therefore, her care and guidance often extends to family members and caregivers. Rebecca also attends on the Palliative Care Service at the VA which performs palliative care consults in the acute hospital setting and in the VA Community Living Center, and provides care to patients in the VA inpatient hospice unit. Rebecca particularly loves the teaching opportunities that come from her clinical work, including teaching fellows, residents, and medical students on the inpatient wards as well as through formal didactic sessions on health literacy, advance care planning, ethics, and geriatrics. Although Rebecca is a clinician researcher, her primary passion is first, and foremost, direct patient care for vulnerable older adults.

      Advance Care Planning
      Health Literacy and Vulnerable Populations
      Medical Decision Making and Health Communication
      Health Disparities

      Rebecca’s primary research focus is on improving advance care planning and medical decision making for vulnerable older adults with limited health literacy. She states, “Making medical decisions, especially about medical care for serious illness, is stressful and intimidating. Given the fractured nature of our healthcare system, many patients and their families feel alone and terrified. Yet, these decisions are that much more difficult for older adults who are unable to read, understand, or process complex medical information and understand their choices.”

      Rebecca has dedicated her research program to making medical information easier for patients and their families to understand. She published the first prospective study demonstrating the effect of limited literacy on mortality in the elderly, and has shown that elders with limited literacy have greater difficulty making medical decisions for informed consent and advance care planning. She has also designed and tested an informed consent process for patients with limited literacy and an advance directive that is both literacy and culturally appropriate. Both interventions have been shown to benefit patients - particularly those with literacy and/or language barriers. Even though her low-literate advance directive has been translated and widely disseminated, further research with patients and surrogate decision makers helped her realize that advance directives alone are not enough. In 2010, she published a study in the Annals of Internal Medicine calling for a shift in advance care planning from DNR/DNI checklists to preparing patients and their loved ones for medical decision making. Her current research program is focused on designing and testing interactive, web-based interventions to prepare patients and their surrogate decision makers to make difficult medical decisions.

      Rebecca is the recipient of numerous awards and grants, including a NIA K23 Award, VA Career Development Award, an RWJ-VA Physician Faculty Scholars Award, a National Palliative Care Research Center Grant, and a VA Investigator Initiated Research Award.

      Collapse Interests
      Implementation Science, Older adults, People with limited English proficiency, Socioeconomically marginalized groups, Migrants/refugees, Clinic, Community-based organization, Department of public health, Decision aids, Education, Health fairs, Support groups, Web site, Advance Care Planning, Medical Decision Making, Health Communication, Health Literacy, Health Disparities, Mentoring junior faculty or trainees, Interdisciplinary research collaboration, Brief implementation science training courses, Works-in-progress seminars, Implementation & dissemination science listservs

      Collapse ORNG Applications 
      Collapse Websites
      Collapse In The News
      Collapse Awarded Grants
      Collapse Clinical Trials

      Collapse Bibliographic 
      Collapse Publications
      Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
      List All   |   Timeline
      1. Sudore RL, Barnes DE, Le GM, Ramos R, Osua SJ, Richardson SA, Boscardin J, Schillinger D. Improving advance care planning for English-speaking and Spanish-speaking older adults: study protocol for the PREPARE randomised controlled trial. BMJ Open. 2016; 6(7):e011705. PMID: 27401363.
        View in: PubMed
      2. Howard M, Bonham AJ, Heyland DK, Sudore R, Fassbender K, Robinson CA, McKenzie M, Elston D, You JJ. Measuring engagement in advance care planning: a cross-sectional multicentre feasibility study. BMJ Open. 2016; 6(6):e010375. PMID: 27338877.
        View in: PubMed
      3. Lakin JR, Isaacs E, Sullivan E, Harris HA, McMahan RD, Sudore RL. Emergency Physicians' Experience with Advance Care Planning Documentation in the Electronic Medical Record: Useful, Needed, and Elusive. J Palliat Med. 2016 Jun; 19(6):632-8. PMID: 27203483.
        View in: PubMed
      4. Tang VL, Shi Y, Fung K, Tan J, Espaldon R, Sudore R, Wong ML, Walter LC. Clinician Factors Associated With Prostate-Specific Antigen Screening in Older Veterans With Limited Life Expectancy. JAMA Intern Med. 2016 May 1; 176(5):654-61. PMID: 27042937.
        View in: PubMed
      5. O'Hare AM, Szarka J, McFarland LV, Taylor JS, Sudore RL, Trivedi R, Reinke LF, Vig EK. Provider Perspectives on Advance Care Planning for Patients with Kidney Disease: Whose Job Is It Anyway? Clin J Am Soc Nephrol. 2016 May 6; 11(5):855-66. PMID: 27084877.
        View in: PubMed
      6. Lum HD, Jones J, Matlock DD, Glasgow RE, Lobo I, Levy CR, Schwartz RS, Sudore RL, Kutner JS. Advance Care Planning Meets Group Medical Visits: The Feasibility of Promoting Conversations. Ann Fam Med. 2016 Mar; 14(2):125-32. PMID: 26951587.
        View in: PubMed
      7. Lum HD, Sudore RL. Advance Care Planning and Goals of Care Communication in Older Adults with Cardiovascular Disease and Multi-Morbidity. Clin Geriatr Med. 2016 May; 32(2):247-60. PMID: 27113144.
        View in: PubMed
      8. Sudore R, Le GM, McMahan R, Feuz M, Katen M, Barnes DE. Erratum to: 'The advance care planning PREPARE study among older Veterans with serious and chronic illness: study protocol for a randomized controlled trial'. Trials. 2016; 17(1):42. PMID: 26791078.
        View in: PubMed
      9. Sudore R, Le GM, McMahon R, Feuz M, Katen M, Barnes DE. The advance care planning PREPARE study among older Veterans with serious and chronic illness: study protocol for a randomized controlled trial. Trials. 2015; 16(1):570. PMID: 26654250.
        View in: PubMed
      10. Chiu C, Feuz MA, McMahan RD, Miao Y, Sudore RL. "Doctor, Make My Decisions": Decision Control Preferences, Advance Care Planning, and Satisfaction With Communication Among Diverse Older Adults. J Pain Symptom Manage. 2016 Jan; 51(1):33-40. PMID: 26342727.
        View in: PubMed
      11. Poelke G, Ventura MI, Byers AL, Yaffe K, Sudore R, Barnes DE. Leisure activities and depressive symptoms in older adults with cognitive complaints. Int Psychogeriatr. 2016 Jan; 28(1):63-9. PMID: 26299193.
        View in: PubMed
      12. Austin CA, Mohottige D, Sudore RL, Smith AK, Hanson LC. Tools to Promote Shared Decision Making in Serious Illness: A Systematic Review. JAMA Intern Med. 2015 Jul; 175(7):1213-21. PMID: 25985438.
        View in: PubMed
      13. Karter AJ, Laiteerapong N, Chin MH, Moffet HH, Parker MM, Sudore R, Adams AS, Schillinger D, Adler NS, Whitmer RA, Piette JD, Huang ES. Ethnic Differences in Geriatric Conditions and Diabetes Complications Among Older, Insured Adults With Diabetes: The Diabetes and Aging Study. J Aging Health. 2015 Aug; 27(5):894-918. PMID: 25659747; PMCID: PMC4498983 [Available on 02/01/16].
      14. Lum HD, Sudore RL, Bekelman DB. Advance care planning in the elderly. Med Clin North Am. 2015 Mar; 99(2):391-403. PMID: 25700590.
        View in: PubMed
      15. Jones J, Nowels CT, Sudore R, Ahluwalia S, Bekelman DB. The future as a series of transitions: qualitative study of heart failure patients and their informal caregivers. J Gen Intern Med. 2015 Feb; 30(2):176-82. PMID: 25385209; PMCID: PMC4314498 [Available on 02/01/16].
      16. Greysen SR, Chin Garcia C, Sudore RL, Cenzer IS, Covinsky KE. Functional impairment and Internet use among older adults: implications for meaningful use of patient portals. JAMA Intern Med. 2014 Jul; 174(7):1188-90. PMID: 24839165; PMCID: PMC4408915.
      17. Sudore RL, Casarett D, Smith D, Richardson DM, Ersek M. Family involvement at the end-of-life and receipt of quality care. J Pain Symptom Manage. 2014 Dec; 48(6):1108-16. PMID: 24793077.
        View in: PubMed
      18. McMahan RD, Sudore R. Authors' Reply to Swetz et al. J Pain Symptom Manage. 2014 Mar; 47(3):e3-4. PMID: 24508005.
        View in: PubMed
      19. Su CT, McMahan RD, Williams BA, Sharma RK, Sudore RL. Family matters: effects of birth order, culture, and family dynamics on surrogate decision-making. J Am Geriatr Soc. 2014 Jan; 62(1):175-82. PMID: 24383459; PMCID: PMC4130561.
      20. Sudore RL, Stewart AL, Knight SJ, McMahan RD, Feuz M, Miao Y, Barnes DE. Development and validation of a questionnaire to detect behavior change in multiple advance care planning behaviors. PLoS One. 2013; 8(9):e72465. PMID: 24039772; PMCID: PMC3764010.
      21. Sudore RL, Knight SJ, McMahan RD, Feuz M, Farrell D, Miao Y, Barnes DE. A novel website to prepare diverse older adults for decision making and advance care planning: a pilot study. J Pain Symptom Manage. 2014 Apr; 47(4):674-86. PMID: 23972574; PMCID: PMC4111443.
      22. Smith AK, Lo B, Sudore R. When previously expressed wishes conflict with best interests. JAMA Intern Med. 2013 Jul 8; 173(13):1241-5. PMID: 23712743; PMCID: PMC3741042.
      23. Allison TA, Sudore RL. Disregard of patients' preferences is a medical error: comment on "Failure to engage hospitalized elderly patients and their families in advance care planning". JAMA Intern Med. 2013 May 13; 173(9):787. PMID: 23545699.
        View in: PubMed
      24. Waite KR, Federman AD, McCarthy DM, Sudore R, Curtis LM, Baker DW, Wilson EA, Hasnain-Wynia R, Wolf MS, Paasche-Orlow MK. Literacy and race as risk factors for low rates of advance directives in older adults. J Am Geriatr Soc. 2013 Mar; 61(3):403-6. PMID: 23379361; PMCID: PMC3891653.
      25. Bischoff KE, Sudore R, Miao Y, Boscardin WJ, Smith AK. Advance care planning and the quality of end-of-life care in older adults. J Am Geriatr Soc. 2013 Feb; 61(2):209-14. PMID: 23350921; PMCID: PMC3760679.
      26. McMahan RD, Knight SJ, Fried TR, Sudore RL. Advance care planning beyond advance directives: perspectives from patients and surrogates. J Pain Symptom Manage. 2013 Sep; 46(3):355-65. PMID: 23200188; PMCID: PMC4111444.
      27. Sudore RL, Karter AJ, Huang ES, Moffet HH, Laiteerapong N, Schenker Y, Adams A, Whitmer RA, Liu JY, Miao Y, John PM, Schillinger D. Symptom burden of adults with type 2 diabetes across the disease course: diabetes & aging study. J Gen Intern Med. 2012 Dec; 27(12):1674-81. PMID: 22854982; PMCID: PMC3509316.
      28. Steinman MA, Sudore RL, Peterson CA, Harlow JB, Fried TR. Influence of patient age and comorbid burden on clinician attitudes toward heart failure guidelines. Am J Geriatr Pharmacother. 2012 Jun; 10(3):211-8. PMID: 22579695; PMCID: PMC3369693.
      29. Vig EK, Sudore RL, Berg KM, Fromme EK, Arnold RM. Responding to surrogate requests that seem inconsistent with a patient's living will. J Pain Symptom Manage. 2011 Nov; 42(5):777-82. PMID: 22045374.
        View in: PubMed
      30. Laiteerapong N, Karter AJ, Liu JY, Moffet HH, Sudore R, Schillinger D, John PM, Huang ES. Correlates of quality of life in older adults with diabetes: the diabetes & aging study. Diabetes Care. 2011 Aug; 34(8):1749-53. PMID: 21636795; PMCID: PMC3142040.
      31. Williams BA, Sudore RL, Greifinger R, Morrison RS. Balancing punishment and compassion for seriously ill prisoners. Ann Intern Med. 2011 Jul 19; 155(2):122-6. PMID: 21628351; PMCID: PMC3163454.
      32. Sudore RL, Covinsky KE. Respecting elders by respecting their paid caregivers. J Gen Intern Med. 2011 May; 26(5):464-5. PMID: 21424164; PMCID: PMC3077494.
      33. Widera E, Steenpass V, Marson D, Sudore R. Finances in the older patient with cognitive impairment: "He didn't want me to take over". JAMA. 2011 Feb 16; 305(7):698-706. PMID: 21325186; PMCID: PMC3799787.
      34. Castillo LS, Williams BA, Hooper SM, Sabatino CP, Weithorn LA, Sudore RL. Lost in translation: the unintended consequences of advance directive law on clinical care. Ann Intern Med. 2011 Jan 18; 154(2):121-8. PMID: 21242368; PMCID: PMC3124843.
      35. Sarkar U, Schillinger D, López A, Sudore R. Validation of self-reported health literacy questions among diverse English and Spanish-speaking populations. J Gen Intern Med. 2011 Mar; 26(3):265-71. PMID: 21057882; PMCID: PMC3043178.
      36. Sudore RL, Fried TR. Redefining the "planning" in advance care planning: preparing for end-of-life decision making. Ann Intern Med. 2010 Aug 17; 153(4):256-61. PMID: 20713793; PMCID: PMC2935810.
      37. Kernisan LP, Sudore RL, Knight SJ. Information-seeking at a caregiving website: a qualitative analysis. J Med Internet Res. 2010; 12(3):e31. PMID: 20675292; PMCID: PMC2956334.
      38. Sudore RL, Villars P, Carey EC. Sitting with you in your suffering: lessons about intractable pain at the end of life. J Palliat Med. 2010 Jun; 13(6):779-82. PMID: 20509794.
        View in: PubMed
      39. Schenker Y, Fernandez A, Sudore R, Schillinger D. Interventions to improve patient comprehension in informed consent for medical and surgical procedures: a systematic review. Med Decis Making. 2011 Jan-Feb; 31(1):151-73. PMID: 20357225.
        View in: PubMed
      40. Sudore RL, Schillinger D, Knight SJ, Fried TR. Uncertainty about advance care planning treatment preferences among diverse older adults. J Health Commun. 2010; 15 Suppl 2:159-71. PMID: 20845201.
        View in: PubMed
      41. Sudore RL. A piece of my mind. Can we agree to disagree? JAMA. 2009 Oct 21; 302(15):1629-30. PMID: 19843890.
        View in: PubMed
      42. Sudore RL, Landefeld CS, Pérez-Stable EJ, Bibbins-Domingo K, Williams BA, Schillinger D. Unraveling the relationship between literacy, language proficiency, and patient-physician communication. Patient Educ Couns. 2009 Jun; 75(3):398-402. PMID: 19442478; PMCID: PMC4068007.
      43. Lee SJ, Sudore RL, Williams BA, Lindquist K, Chen HL, Covinsky KE. Functional limitations, socioeconomic status, and all-cause mortality in moderate alcohol drinkers. J Am Geriatr Soc. 2009 Jun; 57(6):955-62. PMID: 19473456; PMCID: PMC2847409.
      44. Smith AK, Sudore RL, Pérez-Stable EJ. Palliative care for Latino patients and their families: whenever we prayed, she wept. JAMA. 2009 Mar 11; 301(10):1047-57, E1. PMID: 19278947; PMCID: PMC2782583.
      45. Schickedanz AD, Schillinger D, Landefeld CS, Knight SJ, Williams BA, Sudore RL. A clinical framework for improving the advance care planning process: start with patients' self-identified barriers. J Am Geriatr Soc. 2009 Jan; 57(1):31-9. PMID: 19170789; PMCID: PMC2788611.
      46. Sudore RL, Landefeld CS, Pantilat SZ, Noyes KM, Schillinger D. Reach and impact of a mass media event among vulnerable patients: the Terri Schiavo story. J Gen Intern Med. 2008 Nov; 23(11):1854-7. PMID: 18716849; PMCID: PMC2585681.
      47. Sudore RL, Schickedanz AD, Landefeld CS, Williams BA, Lindquist K, Pantilat SZ, Schillinger D. Engagement in multiple steps of the advance care planning process: a descriptive study of diverse older adults. J Am Geriatr Soc. 2008 Jun; 56(6):1006-13. PMID: 18410324.
        View in: PubMed
      48. Williams BA, Lindquist K, Sudore RL, Covinsky KE, Walter LC. Screening mammography in older women. Effect of wealth and prognosis. Arch Intern Med. 2008 Mar 10; 168(5):514-20. PMID: 18332298.
        View in: PubMed
      49. Sudore RL, Landefeld CS, Barnes DE, Lindquist K, Williams BA, Brody R, Schillinger D. An advance directive redesigned to meet the literacy level of most adults: a randomized trial. Patient Educ Couns. 2007 Dec; 69(1-3):165-95. PMID: 17942272; PMCID: PMC2257986.
      50. Sudore RL, Yaffe K, Satterfield S, Harris TB, Mehta KM, Simonsick EM, Newman AB, Rosano C, Rooks R, Rubin SM, Ayonayon HN, Schillinger D. Limited literacy and mortality in the elderly: the health, aging, and body composition study. J Gen Intern Med. 2006 Aug; 21(8):806-12. PMID: 16881938; PMCID: PMC1831586.
      51. Sudore RL, Landefeld CS, Williams BA, Barnes DE, Lindquist K, Schillinger D. Use of a modified informed consent process among vulnerable patients: a descriptive study. J Gen Intern Med. 2006 Aug; 21(8):867-73. PMID: 16881949; PMCID: PMC1831581.
      52. Sudore RL, Mehta KM, Simonsick EM, Harris TB, Newman AB, Satterfield S, Rosano C, Rooks RN, Rubin SM, Ayonayon HN, Yaffe K. Limited literacy in older people and disparities in health and healthcare access. J Am Geriatr Soc. 2006 May; 54(5):770-6. PMID: 16696742.
        View in: PubMed
      53. Williams BA, Lindquist K, Sudore RL, Strupp HM, Willmott DJ, Walter LC. Being old and doing time: functional impairment and adverse experiences of geriatric female prisoners. J Am Geriatr Soc. 2006 Apr; 54(4):702-7. PMID: 16686886.
        View in: PubMed
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