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

Background: The contents of the ship pharmacy, namely "medicine chest" and its compliance with the respective 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. Materials and methods: 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). Results: The investigation showed a lack of homogeneity of contents. It emerged that some medicine chests lack of several pharmaceutical categories required by the reference standards. The subsequent comparison of the European Directive with the WHO Model List of Essential Medicines has highlighted the absence of some therapeutic categories that in the ship environment can be of important to ensure adequate therapy in many situations. Conclusions: There are disparities regarding regulations concerning the ship medicine chests. It is crucial to harmonize these and create a single medicine chest for all the ships without a doctor on board, undergoing periodic updates and revisions, based on epidemiological analysis that will ensure high-quality healthcare to seafarers around the world.