Assessing the knowledge and awareness of community pharmacists toward direct oral anticoagulant therapy in Saudi Arabia: A cross-sectional study

Direct oral anticoagulants (DOACs) have transformed the management of thromboembolic disorders owing to their favorable pharmacologic profiles and ease of use. Despite their increasing use, data on the knowledge of DOACs among community pharmacists are limited, particularly in Saudi Arabia, where pharmacists assume substantial clinical responsibilities. Therefore, this study aimed to assess community pharmacists' knowledge of DOAC therapy in Saudi Arabia, focusing on 3 domains: safety, efficacy, and patient counseling. A cross-sectional survey of 390 community pharmacists across Saudi Arabia was conducted between October and December 2024 using a validated 19-item questionnaire. The percentage awareness score was calculated across 3 domains. The data analysis involved using t-tests and analysis of variance to evaluate the associations between demographic/professional variables and knowledge levels. The mean percentage awareness score was 53.65%, indicating moderate knowledge. Pharmacists showed better understanding of efficacy (56.10%) than of safety (52.82%), or counseling (52.74%). Male pharmacists and those who participated in anticoagulation-related workshops had significantly higher scores than did females and nonparticipants in workshops (P < .002 and < .005, respectively). Education level, experience, and DOAC dispensing frequency were not significantly associated with knowledge. Key gaps included confusion regarding international normalized ratio monitoring, DOAC contraindications, and reversal agents. Community pharmacists in Saudi Arabia possessed moderate knowledge of DOACs; however, notable deficiencies persisted, particularly in the safety and counseling domains. Targeted educational interventions, including case-based and workshop-style learning, are recommended to enhance clinical competency and ensure safe anticoagulation practices in outpatient settings.