OBJECTIVE To investigate the knowledge level and service confidence of community pharmacists regarding anticoagulant medications, analyze influencing factors and their associations, and provide evidence for optimizing community anticoagulation pharmaceutical services.

METHODS A cross-sectional survey was conducted among 198 pharmacists from 48 community health service centers in Pudong New Area, Shanghai from October to November 2025. Anticoagulant knowledge(full score 46) and service confidence(full score 64) were assessed using a structured questionnaire. Independent t-test and ANOVA were used for univariate analysis. Spearman correlation analyzed the association between knowledge and confidence. Multiple linear regression identified independent predictors of confidence.

RESULTS The total knowledge score was (28.89±6.78), with a score rate of 62.8%; the comprehensive confidence score was (35.95±9.87), with a score rate of 56.2%. Rivaroxaban was the most commonly used anticoagulant(46.0% high-frequency contact), while warfarin had almost withdrawn from community use(91.9% rarely contacted). Knowledge weaknesses concentrated on DOACs dosing in renal impairment(38.9%) and drug interaction identification(41.4%). A total of 59.6% pharmacists had never received anticoagulant training. Total knowledge score positively correlated with comprehensive confidence(rs=0.612, P<0.001). Multiple linear regression showed that total knowledge score(β=0.687), training experience(β=3.234), and work experience(β=2.567) were independent predictors of service confidence(all P<0.05).

CONCLUSION Both anticoagulant knowledge and service confidence of community pharmacists need improvement. A systematic training program focusing on DOACs should be established, with emphasis on renal function assessment and drug interaction identification.