Asthma is a major cause of disease burden in Asian children including India where its prevalence is 7.9 percent. Despite therapeutic advances asthma control remains poor especially in low and middle income countries due to limited access to care. Inhaled medications like corticosteroids are key to treatment but effectiveness depends on proper inhaler technique. Metered Dose Inhalers MDIs with spacers are commonly recommended for children but have drawbacks including bulkiness and stigma which may reduce adherence. Breath actuated inhalers BAIs such as Synchro Breathe may improve drug delivery by removing the need for hand breath coordination. However their efficacy in children particularly in India is not well studied.

This randomized controlled trial will compare BAIs and MDIs with spacers in children aged 6 to 18 years at a tertiary hospital in Chandigarh. A total of 70 children will be enrolled and stratified by age. Both groups will receive identical drug formulations. Lung function FEV1 spirometry patient diaries and validated questionnaires will be used. The findings aim to provide evidence based guidance for selecting the most effective and user friendly inhaler devices for pediatric asthma management in resource limited settings.