The number of measures taken per patient was statistically higher in the comorbidity group : 4.542.08 versus 2.651.57 ( p < 0.001 ) ; incidence rate ratio : 1.78 ( 1.61-1 .96 ) and DMARD therapy was changed more frequently in the self-assessment group : 17.2 % versus 10.9 % ( OR = 1.70 ( 1.17 ; 2.49 ) , p = 0.006 ) .