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Poor adherence to inhaled drug therapy is considered to be a major factor in asthma related morbidity and it has been shown, in a significant number of patients, that estimates of adherence by patients or parents of children is not accurate. Inaccurate reporting may lead to higher dose of drug or more potent drugs being prescribed. A number of adherence sensors are available for some commercial inhaler devices. However, existing adherence monitoring mainly focuses on how the hardware of an inhaler has been actuated and does not provide evidence of drug aerosol inhalation. Valved holding chambers are now first choice for aerosol drug delivery for young children, who inhale drug by breathing in and out of the device several times and are increasingly used by older children and adults who inhale drug aerosol by taking a single deep breath. To the best knowledge of the authors, there is no adherence sensor in …