Comparative analysis of the medicinal compounds of the ship's "medicine chests" in European Union maritime countries. Need for improvement and harmonization.

Abstract

The contents of the ship pharmacy, namely "medicine chest" and its compliance with therespective regulations concerning the type of drugs to be provided for merchant vessels involved in long distance voyages and without a doctor on board were analysed. The current existing disparity between regulations can make medical assistance more complicated, and more often of low quality, due to frequent off-label use of supplied drugs. This study may represent a starting point leading to a model high-quality medicine chest on board ships. A comparative analysis between the medicine chest requirements of 12 European countries and the CEE Directive 31 March 1992 n.92/29 was made. Prescriptions of the aforementioned Directive were compared with the WHO Model List of Essential Medicines (third Edition). The investigation showed a lack of homogeneity of contents. It emerged that some medicinechests lack of several pharmaceutical categories required by the reference standards. The subsequentcomparison of the European Directive with the WHO Model List of Essential Medicines has highlightedthe absence of some therapeutic categories that in the ship environment can be of important to ensureadequate therapy in many situations. There are disparities regarding regulations concerning the ship medicine chests. It is crucial toharmonize these and create a single medicine chest for all the ships without a doctor on board, undergoingperiodic updates and revisions, based on epidemiological analysis that will ensure high-quality healthcareto seafarers around the world.