Background: Bronchial asthma, characterized by airway inflammation and hyperresponsiveness, affects millions worldwide, with a significant prevalence in India. Despite effective treatments with inhalation drugs, nonadherence to hand-held devices poses a substantial challenge, leading to uncontrolled symptoms and increased healthcare burden. Aims and objectives: This study aims to investigate the reasons for nonadherence to hand-held inhalation devices in bronchial asthma treatment, identify barriers, and propose strategies for improvement through various intervention approaches. Materials and methods: This qualitative study was conducted at a tertiary medical college in Bihar, India, included 229 patients with uncontrolled bronchial asthma. Data collection involved in-depth interviews (IDIs) and subsequent interventions targeting identified barriers, such as patient education, supply assurance, and behavioral interventions. Data analysis involved transcription, coding, and categorization of interview responses using qualitative research standards. Results: Analysis revealed multifaceted challenges contributing to nonadherence, including treatment costs, inhaler availability, lack of treatment response, and motivational issues. Following interventions, 15% of patients became symptom free, while 40% showed improvement. The study highlighted the importance of interventions in addressing adherence barriers and improving patient outcomes. Conclusion: Despite the challenges, proper interventions targeting identified barriers showed promising results in enhancing bronchial asthma treatment adherence and improving patient conditions. Further research with larger samples and longer follow-up periods is warranted to refine treatment strategies and deepen the understanding of adherence behavior in bronchial asthma patients.