Bridging The Gap- A Comprehensive Review of Medication Adherence in Asthma Management – Factors Affecting Adherence, Smart Inhaler Technology, Interventions and Future Directions.

Asthma needs ongoing preventive therapy, especially inhaled corticosteroids, yet many patients don’t take their medication as prescribed. Poor adherence leads to uncontrolled symptoms, frequent attacks, more reliever and oral steroid use, and higher healthcare costs. This review covers the main barriers: forgetfulness, fear of side effects, treatment beliefs, difficulty using inhalers, poor technique, cost, and weak patient-provider communication. It discusses ways to measure adherence, including self-reporting surveys, pharmacy refill records, dose counters, electronic monitors, and biological assays.Strategies to improve adherence include patient education, behavioural counselling, text reminders, mobile apps, and smart inhalers such as INCA, propeller, Hailie, Turbu+, capmedic, Respiro and hero tracker. The review also highlights clinical pharmacists ‘roles in medication reconciliation, spotting adverse reactions, managing polypharmacy, and personalized care, with attention to children and the elderly. Overall, better adherence needs a combined approach individualized education, regular assessment, suitable inhaler selection, digital tools, and team-based collaboration.