Faculty Profiles

Rebecca Sudore, MD
M_MED-GERI-CORE
Professor

3333 California Street
San Francisco, CA 94118

OVERVIEW:
Dr. Rebecca Sudore is a geriatrician, palliative medicine physician, and clinician investigator. She also directs the Innovation and Implementation Center in Aging & Palliative Care (I-CAP) and the Vulnerable Populations for Aging Research Core of the NIA-funded Pepper Center.


Dr. Sudore conducts research to improve advance care planning and medical decision making for diverse, vulnerable older adults. To this end, she has designed, tested and disseminated innovative, patient centered tools including an easy-to-read advance directive in over 10 languages (http://www.iha4health.org/our-services/advance-directive/) and an interactive, advance care planning website called PREPARE (www.prepareforyourcare.org).


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


Dr. Sudore 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.


She also currently directs the NIA-funded Medical Student Training in Aging Research (MSTAR) program.



CLINICAL ACTIVITIES:
Since 2002, Rebecca has provided primary care to vulnerable, older Veterans in the Geriatrics clinic at the San Francisco VA Medical Center. She also attends on the inpatient Palliative Care Service at the San Francisco VA. Although Dr. Sudore is a clinician researcher, her primary passion is first, and foremost, direct patient care for vulnerable older adults.

Education and Training

Location Degree or Training Specialty Date
University of California, San Francisco Certificate in Implementation Science CTSI 2013
University of California, San Francisco Advance Training in Clinical Research School of Medicine 2004
University of California, San Francisco Geriatrics Clinical Fellowship School of Medicine 2003
University of California, San Francisco Residency School of Medicine 2002
University of California, San Francisco M.D. School of Medicine 1999

Awards and Honors

2016   Induction into the American Society for Clinical Investigation, ASCI, 2016
2015   Outstanding Scientific Achievement for Clinical Investigation, American Geriatrics Society, 2015
2012   Junior Investigator of the Year, Society of General Internal Medicine, 2012
2009   Physician Faculty Scholar, RWJ, 2009-2012
2009   Junior Investigator of the Year, American Geriatrics Society, 2009

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In the News

Recent Articles (72)

Walker E, McMahan R, Barnes D, Katen M, Lamas D, Sudore R. Advance Care Planning Documentation Practices and Accessibility in the Electronic Health Record: Implications for Patient Safety. J Pain Symptom Manage. 2017 Sep 21.

Cresswell MA, Robinson CA, Fyles G, Bottorff JL, Sudore R. Evaluation of an advance care planning web-based resource: applicability for cancer treatment patients. Support Care Cancer. 2017 Sep 19.

Wong TW, Lang-Brown S, Romo RD, Au-Yeung A, Lee SJ, Moran PJ, Karlawish J, Sudore R, Clayton J, Smith AK. Prognosis Communication in Late-Life Disability: A Mixed Methods Study. J Am Geriatr Soc. 2017 Sep 14.

Tulsky JA, Beach MC, Butow PN, Hickman SE, Mack JW, Morrison RS, Street RL, Sudore RL, White DB, Pollak KI. A Research Agenda for Communication Between Health Care Professionals and Patients Living With Serious Illness. JAMA Intern Med. 2017 Sep 01; 177(9):1361-1366.

Ahalt C, Sudore R, Bolano M, Metzger L, Darby AM, Williams B. "Teach-to-Goal" to Better Assess Informed Consent Comprehension among Incarcerated Clinical Research Participants. AMA J Ethics. 2017 Sep 01; 19(9):862-872.

Sudore RL, Heyland DK, Lum HD, Rietjens JAC, Korfage IJ, Ritchie CS, Hanson LC, Meier DE, Pantilat SZ, Lorenz K, Howard M, Green MJ, Simon JE, Feuz MA, You JJ. Outcomes that Define Successful Advance Care Planning: A Delphi Panel Consensus. J Pain Symptom Manage. 2017 Aug 30.

Lum HD, Sudore RL, Matlock DD, Juarez-Colunga E, Jones J, Nowels M, Schwartz RS, Kutner JS, Levy CR. A Group Visit Initiative Improves Advance Care Planning Documentation among Older Adults in Primary Care. J Am Board Fam Med. 2017 Jul-Aug; 30(4):480-490.

Barnato AE, Moore R, Moore CG, Kohatsu ND, Sudore RL. Financial Incentives to Increase Advance Care Planning Among Medicaid Beneficiaries: Lessons Learned From Two Pragmatic Randomized Trials. J Pain Symptom Manage. 2017 Jul; 54(1):85-95.e1.

Bekelman DB, Johnson-Koenke R, Ahluwalia SC, Walling AM, Peterson J, Sudore RL. Development and Feasibility of a Structured Goals of Care Communication Guide. J Palliat Med. 2017 Sep; 20(9):1004-1012.

O'Hare AM, Szarka J, McFarland LV, Vig EK, Sudore RL, Crowley S, Reinke LF, Trivedi R, Taylor JS. "Maybe They Don't Even Know That I Exist": Challenges Faced by Family Members and Friends of Patients with Advanced Kidney Disease. Clin J Am Soc Nephrol. 2017 Jun 07; 12(6):930-938.

Sudore RL, Lum HD, You JJ, Hanson LC, Meier DE, Pantilat SZ, Matlock DD, Rietjens JAC, Korfage IJ, Ritchie CS, Kutner JS, Teno JM, Thomas J, McMahan RD, Heyland DK. Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel. J Pain Symptom Manage. 2017 May; 53(5):821-832.e1.

Sudore RL, Heyland DK, Barnes DE, Howard M, Fassbender K, Robinson CA, Boscardin J, You JJ. Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey. J Pain Symptom Manage. 2017 Apr; 53(4):669-681.e8.

Harrison KL, Adrion ER, Ritchie CS, Sudore RL, Smith AK. Low Completion and Disparities in Advance Care Planning Activities Among Older Medicare Beneficiaries. JAMA Intern Med. 2016 Dec 01; 176(12):1872-1875.

Hickman SE, Hammes BJ, Torke AM, Sudore RL, Sachs GA. The Quality of Physician Orders for Life-Sustaining Treatment Decisions: A Pilot Study. J Palliat Med. 2017 Feb; 20(2):155-162.

Ouchi K, Knabben V, Rivera-Reyes L, Ganta N, Gelfman LP, Sudore R, Hwang U. Preparing Older Adults with Serious Illness to Formulate Their Goals for Medical Care in the Emergency Department. J Palliat Med. 2016 Oct 31.

Tang VL, Sudore R, Cenzer IS, Boscardin WJ, Smith A, Ritchie C, Wallhagen M, Finlayson E, Petrillo L, Covinsky K. Rates of Recovery to Pre-Fracture Function in Older Persons with Hip Fracture: an Observational Study. J Gen Intern Med. 2017 Feb; 32(2):153-158.

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 Jul 11; 6(7):e011705.

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 Jun 23; 6(6):e010375.

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.

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 01; 176(5):654-61.

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 06; 11(5):855-66.

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.

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.

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 Jan 20; 17:42.

Arnett K, Sudore RL, Nowels D, Feng CX, Levy CR, Lum HD. Advance Care Planning. Am J Hosp Palliat Care. 2016 Jan 01; 1049909116666358.

Sudore R, Le GM, McMahan R, 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 Dec 12; 16:570.

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.

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.

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.

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.

Lum HD, Sudore RL, Bekelman DB. Advance care planning in the elderly. Med Clin North Am. 2015 Mar; 99(2):391-403.

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.

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.

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.

McMahan RD, Sudore R. Authors' Reply to Swetz et al. J Pain Symptom Manage. 2014 Mar; 47(3):e3-4.

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.

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.

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.

Smith AK, Lo B, Sudore R. When previously expressed wishes conflict with best interests. JAMA Intern Med. 2013 Jul 08; 173(13):1241-5.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Sudore RL, Covinsky KE. Respecting elders by respecting their paid caregivers. J Gen Intern Med. 2011 May; 26(5):464-5.

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.

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.

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.

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.

Kernisan LP, Sudore RL, Knight SJ. Information-seeking at a caregiving website: a qualitative analysis. J Med Internet Res. 2010 Jul 28; 12(3):e31.

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.

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.

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.

Sudore RL. A piece of my mind. Can we agree to disagree? JAMA. 2009 Oct 21; 302(15):1629-30.

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.

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.

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.

Sudore RL, Schillinger D. Interventions to Improve Care for Patients with Limited Health Literacy. J Clin Outcomes Manag. 2009 Jan 01; 16(1):20-29.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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