Rebecca Sudore, MD

Professor of Medicine, Director, Innovation and Implementation Center in Aging & Palliative Care, Geriatrician, SFVAMC

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
M.D., 1999 - School of Medicine, University of California, San Francisco
Honors and Awards
  • Induction into the American Society for Clinical Investigation, ASCI, 2016
  • Outstanding Scientific Achievement for Clinical Investigation, American Geriatrics Society, 2015
  • Junior Investigator of the Year, Society of General Internal Medicine, 2012
  • Physician Faculty Scholar, RWJ, 2009-2012
  • Junior Investigator of the Year, American Geriatrics Society, 2009
Websites
  • Easy to Read Advance Directive
Publications
  1. Odierna DH, Katen MT, Feuz MA, McMahan RD, Ritchie CS, McSpadden S, Burns M, Volow AM, Sudore RL. Symptom Assessment Solutions for In-Home Supportive Services and Diverse Older Adults: A Roadmap for Change. 2018. PMID: 29851360


  2. Hickman SE, Sudore RL, Sachs GA, Torke AM, Myers AL, Tang Q, Bakoyannis G, Hammes BJ. Use of the Physician Orders for Scope of Treatment Program in Indiana Nursing Homes. 2018. PMID: 29566429


  3. Ouchi K, Jambaulikar GD, Hohmann S, George NR, Aaronson EL, Sudore R, Schonberg MA, Tulsky JA, Schuur JD, Pallin DJ. Prognosis After Emergency Department Intubation to Inform Shared Decision-Making. 2018. PMID: 29542117


  4. Bischoff K, O'Riordan DL, Marks AK, Sudore R, Pantilat SZ. Care Planning for Inpatients Referred for Palliative Care Consultation. Volume 178 of Issue 1. 2018. PMID: 29159371


  5. Givens JL, Sudore RL, Marshall GA, Dufour AB, Kopits I, Mitchell SL. Advance Care Planning in Community-Dwelling Patients With Dementia. Volume 55 of Issue 4. 2017. PMID: 29247754


  6. Quartuccio M, Simonsick EM, Langan S, Harris T, Sudore RL, Thorpe R, Rosano C, Hill-Briggs F, Golden S, Kalyani RR. The relationship of health literacy to diabetes status differs by sex in older adults. Volume 32 of Issue 4. 2017. PMID: 29198996


  7. 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. Volume 55 of Issue 2. 2017. PMID: 28943360


  8. Cresswell MA, Robinson CA, Fyles G, Bottorff JL, Sudore R. Evaluation of an advance care planning web-based resource: applicability for cancer treatment patients. Volume 26 of Issue 3. 2017. PMID: 28929291


  9. 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. Volume 65 of Issue 11. 2017. PMID: 28905358


  10. 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. Volume 19 of Issue 9. 2017. PMID: 28905727


  11. 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. Volume 177 of Issue 9. 2017. PMID: 28672373


  12. Rietjens JAC, Sudore RL, Connolly M, van Delden JJ, Drickamer MA, Droger M, van der Heide A, Heyland DK, Houttekier D, Janssen DJA, Orsi L, Payne S, Seymour J, Jox RJ, Korfage IJ. Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care. Volume 18 of Issue 9. 2017. PMID: 28884703


  13. 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. Volume 55 of Issue 2. 2017. PMID: 28865870


  14. Sudore RL, Boscardin J, Feuz MA, McMahan RD, Katen MT, Barnes DE. Effect of the PREPARE Website vs an Easy-to-Read Advance Directive on Advance Care Planning Documentation and Engagement Among Veterans: A Randomized Clinical Trial. Volume 177 of Issue 8. 2017. PMID: 28520838


  15. 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. Volume 30 of Issue 4. 2017. PMID: 28720629


  16. 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. Volume 54 of Issue 1. 2017. PMID: 28450218


  17. Bekelman DB, Johnson-Koenke R, Ahluwalia SC, Walling AM, Peterson J, Sudore RL. Development and Feasibility of a Structured Goals of Care Communication Guide. Volume 20 of Issue 9. 2017. PMID: 28422561


  18. 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. Volume 12 of Issue 6. 2017. PMID: 28356337


  19. 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. Volume 53 of Issue 5. 2017. PMID: 28062339


  20. 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. Volume 53 of Issue 4. 2016. PMID: 28042072


  21. Harrison KL, Adrion ER, Ritchie CS, Sudore RL, Smith AK. Low Completion and Disparities in Advance Care Planning Activities Among Older Medicare Beneficiaries. Volume 176 of Issue 12. 2016. PMID: 27802496


  22. Hickman SE, Hammes BJ, Torke AM, Sudore RL, Sachs GA. The Quality of Physician Orders for Life-Sustaining Treatment Decisions: A Pilot Study. Volume 20 of Issue 2. 2016. PMID: 27802064


  23. 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. 2016. PMID: 27797638


  24. 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. Volume 32 of Issue 2. 2016. PMID: 27605004


  25. Arnett K, Sudore RL, Nowels D, Feng CX, Levy CR, Lum HD. Advance Care Planning: Understanding Clinical Routines and Experiences of Interprofessional Team Members in Diverse Health Care Settings. Volume 34 of Issue 10. 2016. PMID: 27599724


  26. 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. Volume 6 of Issue 7. 2016. PMID: 27401363


  27. 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. Volume 6 of Issue 6. 2016. PMID: 27338877


  28. 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. Volume 19 of Issue 6. 2016. PMID: 27203483


  29. 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. Volume 176 of Issue 5. 2016. PMID: 27042937


  30. 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? Volume 11 of Issue 5. 2016. PMID: 27084877


  31. 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. Volume 14 of Issue 2. 2016. PMID: 26951587


  32. 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. Volume 16. 2015. PMID: 26654250


  33. Poelke G, Ventura MI, Byers AL, Yaffe K, Sudore R, Barnes DE. Leisure activities and depressive symptoms in older adults with cognitive complaints. Volume 28 of Issue 1. 2015. PMID: 26299193


  34. Austin CA, Mohottige D, Sudore RL, Smith AK, Hanson LC. Tools to Promote Shared Decision Making in Serious Illness: A Systematic Review. Volume 175 of Issue 7. 2015. PMID: 25985438


  35. 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. Volume 27 of Issue 5. 2015. PMID: 25659747


  36. Lum HD, Sudore RL, Bekelman DB. Advance care planning in the elderly. Volume 99 of Issue 2. 2014. PMID: 25700590


  37. 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. Volume 30 of Issue 2. 2014. PMID: 25385209


  38. 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. Volume 174 of Issue 7. 2014. PMID: 24839165


  39. Sudore RL, Casarett D, Smith D, Richardson DM, Ersek M. Family involvement at the end-of-life and receipt of quality care. Volume 48 of Issue 6. 2014. PMID: 24793077


  40. McMahan RD, Sudore R. Authors' Reply to Swetz et al. Volume 47 of Issue 3. 2014. PMID: 24508005


  41. Su CT, McMahan RD, Williams BA, Sharma RK, Sudore RL. Family matters: effects of birth order, culture, and family dynamics on surrogate decision-making. Volume 62 of Issue 1. 2014. PMID: 24383459


  42. 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. Volume 8 of Issue 9. 2013. PMID: 24039772


  43. 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. Volume 47 of Issue 4. 2013. PMID: 23972574


  44. Smith AK, Lo B, Sudore R. When previously expressed wishes conflict with best interests. Volume 173 of Issue 13. 2013. PMID: 23712743


  45. 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. Volume 61 of Issue 3. 2013. PMID: 23379361


  46. Bischoff KE, Sudore R, Miao Y, Boscardin WJ, Smith AK. Advance care planning and the quality of end-of-life care in older adults. Volume 61 of Issue 2. 2013. PMID: 23350921


  47. McMahan RD, Knight SJ, Fried TR, Sudore RL. Advance care planning beyond advance directives: perspectives from patients and surrogates. Volume 46 of Issue 3. 2012. PMID: 23200188


  48. 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. Volume 27 of Issue 12. 2012. PMID: 22854982


  49. Steinman MA, Sudore RL, Peterson CA, Harlow JB, Fried TR. Influence of patient age and comorbid burden on clinician attitudes toward heart failure guidelines. Volume 10 of Issue 3. 2012. PMID: 22579695


  50. Vig EK, Sudore RL, Berg KM, Fromme EK, Arnold RM. Responding to surrogate requests that seem inconsistent with a patient's living will. Volume 42 of Issue 5. 2011. PMID: 22045374


  51. 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. Volume 34 of Issue 8. 2011. PMID: 21636795


  52. Williams BA, Sudore RL, Greifinger R, Morrison RS. Balancing punishment and compassion for seriously ill prisoners. Volume 155 of Issue 2. 2011. PMID: 21628351


  53. Sudore RL, Covinsky KE. Respecting elders by respecting their paid caregivers. Volume 26 of Issue 5. 2011. PMID: 21424164


  54. Widera E, Steenpass V, Marson D, Sudore R. Finances in the older patient with cognitive impairment: "He didn't want me to take over". Volume 305 of Issue 7. 2011. PMID: 21325186


  55. 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. Volume 154 of Issue 2. 2011. PMID: 21242368


  56. Sarkar U, Schillinger D, López A, Sudore R. Validation of self-reported health literacy questions among diverse English and Spanish-speaking populations. Volume 26 of Issue 3. 2010. PMID: 21057882


  57. Sudore RL, Fried TR. Redefining the "planning" in advance care planning: preparing for end-of-life decision making. Volume 153 of Issue 4. 2010. PMID: 20713793


  58. Kernisan LP, Sudore RL, Knight SJ. Information-seeking at a caregiving website: a qualitative analysis. Volume 12 of Issue 3. 2010. PMID: 20675292


  59. Sudore RL, Villars P, Carey EC. Sitting with you in your suffering: lessons about intractable pain at the end of life. Volume 13 of Issue 6. 2010. PMID: 20509794


  60. Schenker Y, Fernandez A, Sudore R, Schillinger D. Interventions to improve patient comprehension in informed consent for medical and surgical procedures: a systematic review. Volume 31 of Issue 1. 2010. PMID: 20357225


  61. Sudore RL, Schillinger D, Knight SJ, Fried TR. Uncertainty about advance care planning treatment preferences among diverse older adults. Volume 15 Suppl 2. 2010. PMID: 20845201


  62. Sudore RL. A piece of my mind. Can we agree to disagree? Volume 302 of Issue 15. 2009. PMID: 19843890


  63. 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. Volume 75 of Issue 3. 2009. PMID: 19442478


  64. Lee SJ, Sudore RL, Williams BA, Lindquist K, Chen HL, Covinsky KE. Functional limitations, socioeconomic status, and all-cause mortality in moderate alcohol drinkers. Volume 57 of Issue 6. 2009. PMID: 19473456


  65. Smith AK, Sudore RL, Pérez-Stable EJ. Palliative care for Latino patients and their families: whenever we prayed, she wept. Volume 301 of Issue 10. 2009. PMID: 19278947


  66. 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. Volume 57 of Issue 1. 2009. PMID: 19170789


  67. Sudore RL, Schillinger D. Interventions to Improve Care for Patients with Limited Health Literacy. Volume 16 of Issue 1. 2009. PMID: 20046798


  68. 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. Volume 23 of Issue 11. 2008. PMID: 18716849


  69. 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. Volume 56 of Issue 6. 2008. PMID: 18410324


  70. Williams BA, Lindquist K, Sudore RL, Covinsky KE, Walter LC. Screening mammography in older women. Effect of wealth and prognosis. Volume 168 of Issue 5. 2008. PMID: 18332298


  71. 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. Volume 69 of Issue 1-3. 2007. PMID: 17942272


  72. 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. Volume 21 of Issue 8. 2006. PMID: 16881938


  73. 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. Volume 21 of Issue 8. 2006. PMID: 16881949


  74. 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. Volume 54 of Issue 5. 2006. PMID: 16696742


  75. 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. Volume 54 of Issue 4. 2006. PMID: 16686886