The interesting study by Patel et al1 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 al1 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 al1 did measure educational attainment; however, Williams et al2 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 communication.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.