The evolving landscape of digital inhaler platforms and adherence support in chronic airways disease

Inhaled therapies remain the cornerstone in managing chronic airway diseases, offering direct treatment delivery to the lungs with minimal systemic adverse effects. With advancements in respiratory care, digital inhalers have emerged as a transformative innovation. Their functions extend beyond delivering inhaled medication, providing deeper insights into patients' medication use behaviour and intervening through complementary platform features and integrated data analytics. However, despite being available for over two decades, the widespread adoption of digital inhaler platforms remains limited due to uncertainties regarding their cost-effectiveness, feasibility in real-world settings, and concerns regarding sustainability. Identifying patient groups that could benefit most from these technologies and designing strategies for effective deployment across diverse healthcare contexts is important. To achieve this, bridging the gap between innovation and accessibility is required so that digital inhaler platforms evolve into inclusive, patient-centred tools rather than niche technologies. This narrative review provides a summary of the evolution and current landscape of digital inhaler technology, its impact on clinical outcomes in chronic airway disease, and key challenges that stakeholders should address for the successful integration of these tools into respiratory care. We also propose key components of a patient-centred digital inhaler adherence support model that prioritises accessibility and efficacy.