Background: The provision of healthcare for seafarers is challenging due to their isolated working conditions and limited access to healthcare. Telemedical maritime assistance relies on pre-stocked medical chests aboard vessels. However, the contents of these medical chests are not globally standardized, and current data on prescription patterns is limited.
Material and methods: A retrospective observational cohort study was conducted, analyzing medical records from ships that received telemedical assistance between 2021 and 2023. Data were obtained from medical reports submitted by onboard medical officers and an internal medical record registry.
Results: In total, 9,458 individual patients received medical assistance, and 11,698 medications were prescribed. The mean patient age was 38.7 years (range 0–91 years), and patients aged 30–49 years were the most likely to receive medication. Merchant ships were the most common type of vessel requiring medical assistance, and they also had the highest probability for drug prescriptions. Approximately 80% of patients were prescribed medications, and patients required on average 1.24 prescriptions (range 0–6). A total of 266 individual types of medication were available for prescription. Overall, patient demographics and prescription patterns did not change over the three-year period.
Conclusions: The prescription patterns in the treatment of acutely ill seafarers are highly variable due to excessive availability of different drugs. The rare use of certain medications suggests potential inefficiencies in the stock management of medical chests, warranting further evaluation. These findings underscore the need for standardizing medical chests based on a data-driven approach. Medication use in telemedical care of seafarers is frequent but highly variable. A data-driven standardization of medical chests may improve efficiency and ensure availability of essential drugs.
INTRODUCTION. Seafaring is associated with higher occupational hazards and health risks than shore-based work. Telemedical maritime assistance services (TMAS) provide remote specialist medical support to seafarers. In Denmark, a unified national TMAS, Radio Medical Denmark (RMD), was established in 1995. This study aimed to describe the 30-year development and clinical activity of the RMD.
METHODS. This was a single-centre retrospective cohort study of all consultations provided by the RMD from 1 September 1995 to 31 December 2024. Data were extracted from annual reports based on original medical files, with organisational information from contracts and guidelines. No identifiable patient data were collected.
RESULTS. The RMD assisted 49,999 seafarers over 30 years, with annual consultations increasing from 240 in 1995 to 4,829 in 2024. The proportion requiring disembarkation or evacuation declined from >10% at the outset to approximately 5% today. The most common diagnoses were musculoskeletal (18.8%), dermatological (14.6%) and abdominal (11.5%). Since 2014, the proportion of Danish seafarers decreased from 38% to 15.1%, while Indian and Filipino seafarers increased substantially. Merchant vessels accounted for 55.7% of contacts, predominantly in the North Sea.
CONCLUSIONS. RMD has evolved into one of Europe’s largest public TMAS providers. Centralisation within an academic emergency department, combined with structured training and research, has supported sustained growth, improved decision-making and reduced evacuation rates.
FUNDING. None.
TRIAL REGISTRATION. Not relevant.