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    Rebecca Sudore, MD

    TitleAssociate Professor
    SchoolUCSF School of Medicine
    DepartmentMedicine
    Address4150 Clement Street
    San Francisco CA 94143
    Phone415-221-4810x3475

       Biography 
       Education and Training
      Institution Degree School or Department Year
      University of California, San Francisco Residency School of Medicine
      University of California, San FranciscoM.D.School of Medicine1998
       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

       Overview 
       Overview
      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.


      CLINICAL ACTIVITIES:
      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.


      RESEARCH INTERESTS
      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.

       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

       ORNG Applications 
       Websites
       In The News
       Awarded Grants
       More Info

       Bibliographic 
       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. 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 May 16.
        View in: PubMed
      2. McMahan RD, Sudore R. Authors' Reply to Swetz et al. J Pain Symptom Manage. 2014 Mar; 47(3):e3-4.
        View in: PubMed
      3. 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 2.
        View in: PubMed
      4. 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.
        View in: PubMed
      5. 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.
        View in: PubMed
      6. Smith AK, Lo B, Sudore R. When previously expressed wishes conflict with best interests. JAMA Intern Med. 2013 Jul 8; 173(13):1241-5.
        View in: PubMed
      7. 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.
        View in: PubMed
      8. 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.
        View in: PubMed
      9. 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.
        View in: PubMed
      10. 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.
        View in: PubMed
      11. 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.
        View in: PubMed
      12. 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.
        View in: PubMed
      13. 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.
        View in: PubMed
      14. 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.
        View in: PubMed
      15. 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.
        View in: PubMed
      16. Sudore RL, Covinsky KE. Respecting elders by respecting their paid caregivers. J Gen Intern Med. 2011 May; 26(5):464-5.
        View in: PubMed
      17. 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.
        View in: PubMed
      18. 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.
        View in: PubMed
      19. Sudore R, Castillo L, Williams B, Hooper S, Sabatino C. The clash between advance directive law and clinical care: ramifications for vulnerable populations (415-C). J Pain Symptom Manage. 2011 Jan; 41(1):235-6.
        View in: PubMed
      20. 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.
        View in: PubMed
      21. 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.
        View in: PubMed
      22. Kernisan LP, Sudore RL, Knight SJ. Information-seeking at a caregiving website: a qualitative analysis. J Med Internet Res. 2010; 12(3):e31.
        View in: PubMed
      23. 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.
        View in: PubMed
      24. 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.
        View in: PubMed
      25. 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.
        View in: PubMed
      26. Sudore RL. A piece of my mind. Can we agree to disagree? JAMA. 2009 Oct 21; 302(15):1629-30.
        View in: PubMed
      27. 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.
        View in: PubMed
      28. 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.
        View in: PubMed
      29. 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.
        View in: PubMed
      30. 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.
        View in: PubMed
      31. 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.
        View in: PubMed
      32. 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.
        View in: PubMed
      33. 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.
        View in: PubMed
      34. 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.
        View in: PubMed
      35. 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.
        View in: PubMed
      36. 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.
        View in: PubMed
      37. 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.
        View in: PubMed
      38. 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.
        View in: PubMed
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