Health literacy influences self-management behavior in asthma.

The interesting study by Patel et al 1 in an issue of CHEST (November 2012) demonstrated that asthma self-management strategies, patient-physician communication, and patient satisfaction were lower among female individuals who did not have an asthma action plan. Therefore, Patel et al 1 concluded that the use of asthma action plans may enhance clinical-patient relationships and self-management efforts in patients with asthma. Of note, the authors did not measure the participants’ health literacy status in their analysis. In their study, Patel et al 1 did measure educational attainment; however, Williams et al 2 showed that years of schooling do not necessarily predict reading ability. Furthermore, studies indicate that lower health literacy is associated with lower satisfaction with asthma status, a lower likelihood of participation in asthma management, and poor metered dose inhaler skills. 2 , 3 Studies also suggest that low health literacy may serve as a potential mediator of poor patient-physician com munication. 4 , 5 Given this possible limitation, future studies should consider measuring health literacy status when ascertaining self-management behavior and patient-physician communication when dealing with chronic illnesses such as asthma.