Adherence to asthma and COPD inhaled therapies in low- and middle-income countries: a narrative review

Introduction: In low-income and middle-income countries (LIMCs), defined based on the World Bank classification, non-adherence to respiratory therapies contributes to increasing mortality and morbidity due to chronic respiratory diseases. To address this issue, it is essential to identify and tackle underlying factors such as cultural beliefs, socioeconomic disparities, and limited access to healthcare resources and infrastructures. The absence of strategies that integrate community involvement, healthcare professional’s training, economic policies, and educational programs exacerbates the disproportionate burden of chronic respiratory diseases in LIMCs. Areas covered: This review is based on a structured literature search across PubMed, Scopus, and Google Scholar (2000–2023) using terms relevant to asthma, COPD, adherence, and LMICs. The review examines key factors that hinder patients’ adherence to Asthma and COPD medications in LIMCs, providing some insights into the issue and proposing concrete solutions. Expert opinion: Addressing non-adherence requires a multifaceted approach involving community engagement, educational initiatives, and improved healthcare infrastructure. Future research should focus on tailored interventions to enhance adherence and ultimately improve health outcomes for patients with chronic respiratory diseases in LMICs.