Pharmacists’ self-reported confidence in providing pharmaceutical care on anticoagulants in Saudi Arabia

Background: Anticoagulant therapy is high-risk and requires pharmacists to be highly competent in its management. In Saudi Arabia, the confidence of pharmacists in providing such care is not well-established. This study aimed to assess the self-reported confidence levels of pharmacists in Saudi Arabia regarding the provision of pharmaceutical care for patients on anticoagulants. Methods: A cross-sectional online survey was distributed to pharmacists across various healthcare settings in Saudi Arabia. The questionnaire assessed confidence across multiple domains of anticoagulant care, including knowledge, adverse event management, and patient counseling. Data were summarized using descriptive statistics. Confidence scores were compared across groups with t-tests, and predictors were analyzed using logistic regression. Results: Among 194 respondents, overall self-reported confidence was moderate (70.3%). While a strong majority felt confident in foundational tasks, such as discussing indications and benefits (over 79%) and adverse effects (71%), considerably lower confidence was reported in managing critical scenarios, including controlling bleeding events (~60%). This indicates a disparity between theoretical knowledge and confidence in practical application. Hospital pharmacists reported higher confidence levels than community pharmacists. The most frequently referenced resources were Lexicomp (18.6%) and clinical guidelines (17.5%). Conclusions: While Saudi pharmacists report foundational knowledge of anticoagulants, a significant confidence gap exists in the management of serious complications. These findings suggest that continuing education programs should move beyond theoretical knowledge and focus intensively on practical, case-based training in bleeding management and emergency response. A key limitation of this study is its reliance on self-reported data, which may not reflect objective competence.