Background Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease requiring a long-term therapeutic approach. Low compliance with medication leads to the worsening of the disease. Evaluating medication compliance rates and factors associated with low compliance are important to design further compliance interventions.

Methods We conducted a cross-sectional analysis of adult individuals with SLE from Tittari Community, Surakarta. Patient completed the 5-item version of Compliance Questionnaire for Rheumatology (CQR5), Quick Systemic Lupus Activity questionnaire (Q-SLAQ), and Hamilton Anxiety Depression Rating Scale (HADS). Association between compliance and demographic, disease-related characteristics, and medication characteristics were explored.

Results A total of 78 individuals with SLE participated in the study, 76 (96.4%) were female with a mean age of 36±10.9 years. The Majority of SLE patients reported disease duration >5 years (52.7%), were prescribed <5 drugs (52.7%) and had side effect complaints in 28 (35.89%). Low compliance was found in 29.49% of patients. In logistic regression analysis, having mental health issues such as anxiety (OR 4.3, CI 95% 0.6–28.7), depression (OR 3.7, CI 95% 0.9–14.1), or both anxiety and depression (OR 2.6, CI 95% 0.5–13.5) tend to increase the risk of low compliance. Other factors associated with low compliance were disease duration of 1–3 years (OR 4.9, CI 95% 0.5–47.7), and the presence of medication adverse events (OR 1.7, CI 95% 0.6–5.1).

Conclusions The prevalence of low medication compliance among SLE patients was high. SLE patients with anxiety and/or depression who had been living with the disease for 1–3 years, or experienced medication adverse events were found to have a higher risk of low compliance.