Conclusion
The study reiterated the fact that poor inhaler technique is a common
problem with patients on inhaler therapy. Spirometry is a simple,
convenient tool and widely available instructed where measuring urinary
concentration through HPLC is a tedious and complex process which makes
it unlikely to be accepted to use on a routine basis in a clinical
setup. Assessing the optimal inhaler technique through measurement of
urinary salbutamol concentration is likely to be better than measuring
the pulmonary function through spirometry alone but it comes with the
cost. The 30-minute urinary concentration of salbutamol was linear with
inhaled dose and the results of this study witnessed it to correlate
with the control status of the disease. It may help to identify patients
who were under-dosed due to poor handling of inhaler devices and provide
appropriate training and monitoring. Understanding the complexity
coupled with the procedure, this method can at least be initiated in
patients reporting frequent exacerbations, hospitalization, and those
who need multiple drugs for disease control.